射频消融术与激光腔内闭合术联合高位结扎治疗下肢静脉曲张的临床疗效比较  

Comparison of clinical efficacy between radiofrequency ablation endovenous laser treatment combined with high ligation in the treatment of lower extremity varicose veins

作　　者：陈昱名 魏森 朱健 CHEN Yuming;WEI Sen;ZHU Jian(Department of Vascular Surgery,The First People's Hospital of Kunshan,Kunshan 215300,China)

机构地区：[1]昆山市第一人民医院血管外科,江苏昆山215300

出　　处：《山东医药》2025年第2期66-69,共4页Shandong Medical Journal

基　　金：江苏省卫生健康委科研项目(Z2022096);江苏省昆山市科技专项(KS2408)。

摘　　要：目的比较射频消融术(RFA)与激光腔内闭合术(EVLT)联合高位结扎治疗下肢静脉曲张的临床疗效。方法选择137例下肢静脉曲张患者,根据手术方式不同分为RFA组47例、EVLT组90例。RFA组予RFA治疗,EVLT组予EVLT联合高位结扎治疗。比较两组术中出血量、围手术期血流动力学指标、住院时间,术后24 h采用疼痛数字评价量表(NRS)评价患者疼痛程度,分别于术前及术后6个月采用静脉临床严重程度(VCSS)评分及深静脉瓣膜功能Kistner分级评价临床疗效。观察术后6个月内并发症(隐神经损伤、皮下出血、切口感染)发生情况。结果两组术中出血量、围手术期血液动力学指标、术后24 h NRS评分及住院时间比较差异均无统计学意义(P均>0.05)。与术前相比,术后6个月两组VCSS评分均降低(P均<0.05);与EVLT组相比,术后6个月RFA组VCSS评分低(P<0.05)。术前及术后6个月时两组Kistner分级评分及术后并发症发生情况比较差异均无统计学意义(P均>0.05)。结论相比于EVLT联合高位结扎,RFA治疗下肢静脉曲张的临床效果较好,可有效改善下肢静脉曲张程度。Objective To compare the clinical efficacy between radiofrequency ablation(RFA)and endovenous la ser treatment(EVLT)combined with high ligation in the treatment of lower extremity varicose veins.Methods Totally 137 patients with lower extremity varicose veins were divided into RFA group(47 cases)and EVLT group(90 cases)ac cording to different surgical methods.Patients in the RFA group received RFA treatment,while patients of the EVLT group received EVLT combined with high ligation.Intraoperative bleeding volume,perioperative hemodynamic indexes and length of hospital stay were compared between the two groups.The pain degree of the patients was evaluated by numeri cal rating scale(NRS)at 24 h after surgery.The clinical efficacy was evaluated by venous clinical severity score(VCSS)and Kistner classification of deep venous valve function before and 6 months after surgery,respectively.Meanwhile,the occurrence of complications(such as saphenous nerve injury,subcutaneous hemorrhage and incision infection)within 6 months after surgery were observed.Results There were no statistically significant differences in intraoperative bleeding volume,perioperative hemodynamic indexes,postoperative 24-hour NRS,and length of hospital stay between the two groups(all P>0.05).However,VCSSs in both groups decreased at 6 months after surgery as compared with those before surgery(all P<0.05);compared with EVLT group,the VCSS was lower in the RFA group at 6 months after surgery.At the same time,there were no statistically significant differences in the Kistner classification or incidence of postoperative complications between the two groups before and 6 months after surgery(all P>0.05).Conclusion Compared with EV LT combined with high ligation,RFA has a better clinical effect in the treatment of lower limb varicose veins and can effec tively improve the degree of lower limb varicose veins.

关 键 词：射频消融术 激光改良高位结扎剥脱术 下肢静脉曲张 

分 类 号：R658.2[医药卫生—外科学]