腔内微波消融闭合术治疗穿通静脉功能不全的临床研究  

A clinical study of endovenous microwave ablation in the treatment of incompetent perforating veins

作　　者：周冠洲 卢军峰 赵呈祥 吴书圣 尹月蕾 张汝铭 段友良 Zhou Guanzhou;Lu Junfeng;Zhao Chengxiang;Wu Shusheng;Yin Yuelei;Zhang Ruming;Duan Youliang(Department of Vascular Surgery,Shandong Provincial Third Hospital Affiliated to Shandong University,Jinan 250031,China)

机构地区：[1]山东大学附属省立第三医院血管外科,济南250031

出　　处：《中华血管外科杂志》2024年第5期328-334,共7页Chinese Journal of Vascular Surgery

基　　金：山东省医药卫生科技发展计划项目(2017WS791)。

摘　　要：目的评价超声引导下腔内微波消融闭合术(EMWA)治疗穿通静脉功能不全(IPVs)的疗效。方法本研究为回顾性纵向研究。回顾性分析2020年7月至2021年7月山东大学附属省立第三医院血管外科采用超声引导下EMWA治疗的138例IPVs患者(148条患肢, 295条IPVs)的临床资料。观察分析患者术后2周、3个月及1年的并发症、静脉临床严重程度评分(VCSS)和IPVs闭合率的情况。结果共纳入138例患者, 其中男性66例, 女性72例, 年龄(57.67±10.82)岁。138例患者均完成1年随访, 随访期间患者术后并发症情况随时间的延长逐渐改善, 未出现皮肤坏死情况, 无死亡事件。患者术后2周、3个月及1年的VCSS评分随时间逐渐改善, 差异有统计学意义(F=335.843, P<0.001), IPVs闭合率分别为100%(295/295)、96.6%(285/295)及92.2%(273/296)。术前与术后1年IPVs部位分布情况的差异无统计学意义(χ^(2)=0.916, P=0.632)。术前与术后1年IPVs直径分布情况的差异无统计学意义(χ^(2)=0.286, P=0.867)。结论超声引导下EMWA治疗IPVs, 术后随访无严重并发症;患者术后VCSS评分较术前明显改善, IPVs闭合情况确切, 且其直径和分布部位对IPVs闭合率影响较小。Objective:To evaluate the effectiveness of endovenous microwave ablation(EMWA)in treating incompetent perforating veins(IPVs).Methods:In this retrospective longitudinal study,clinical data of patients undergoing color Doppler ultrasound-guided EMWA for IPVs treatment at Shandong Provincial Third Hospital Affiliated to Shandong University from July 2020 to July 2021 were collected,in which a total of 138 cases(148 limbs,295 IPVs)was included.The study assessed the IPV closure rates,Venous Clinical Severity Score(VCSS),and complications at two weeks,three months,and one year postoperatively.Results:A total of 138 patients were included,including 66males and 72 females,aged(57.67±10.82)years.The 1-year follow-up was completed among the 138 cases.During that period,the postoperative complications gradually improved over time,with no occurrence of skin necrosis or death events.Postoperative VCSS scores showed a significant improvement at two weeks,three months,and one year over time,with statistically significant differences(F=335.843,P<0.001).The IPV closure rate was 100%(295/295)at two weeks,96.6%(285/295)at three months,and 92.2%(273/296)at one year postoperatively.No statistically significant differences occurred in the distribution of IPVs at different locations(χ^(2)=0.916,P=0.632)or of different diameters(χ^(2)=0.286,P=0.867)before and one year after the surgery.Conclusion:Color Doppler ultrasound-guided EMWA for treating IPVs is a safe procedure with no severe complications during the follow-up.There was an improvement in the VCSS scores and IPV closure was definitive,with minimal influence from IPV diameter or location.

关 键 词：腔内微波消融闭合术 穿通静脉功能不全 超声 泡沫硬化剂 

分 类 号：R47[医药卫生—护理学]