腔内射频消融术与高位结扎术治疗下肢静脉曲张的疗效  

Efficacy of intracavitary radiofrequency ablation and high ligation in the treatment of varicose veins of lower extremity

作　　者：邱业银 杨军 雷敏 赖筱珊 陈婉红 Qiu Yeyin;Yang Jun;Lei Min;Lai Xiaoshan;Chen Wanhong(Department of Emergency,Zunyi Medical University Fifth Affiliated(Zhuhai)Hospital,Zhuhai 519100,Guangdong,China;Department of Vascular Surgery,Zunyi Medical University Fifth Affiliated(Zhuhai)Hospital,Zhuhai 519100,Guangdong,China;Department of Nursing,Zunyi Medical University Fifth Affiliated(Zhuhai)Hospital,Zhuhai 519100,Guangdong,China;Department of Outpatient,Zunyi Medical University Fifth Affiliated(Zhuhai)Hospital,Zhuhai 519100,Guangdong,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院急诊科,广东珠海519100 [2]遵义医科大学第五附属(珠海)医院血管外科,广东珠海519100 [3]遵义医科大学第五附属(珠海)医院护理部,广东珠海519100 [4]遵义医科大学第五附属(珠海)医院门诊,广东珠海519100

出　　处：《血管与腔内血管外科杂志》2025年第3期382-386,共5页Journal of Vascular and Endovascular Surgery

基　　金：珠海市科技计划项目(ZH22036201210104PWC)。

摘　　要：目的探讨腔内射频消融术(RFA)与高位结扎术(HLS)治疗下肢静脉曲张(VVLE)的疗效。方法收集2021年1月至2022年6月于遵义医科大学第五附属(珠海)医院就诊的72例VVLE患者的临床资料,按照治疗方法的不同将其分为手术组(n=36,采用高位结扎术治疗)和消融组(n=36,采用腔内射频消融术治疗)。比较两组患者术后恢复指标、手术指标并发症发生率。术后6个月随访,比较两组患者静脉曲张情况、大隐静脉功能、生活质量、自我效能、预后复发率、远期疗效。结果消融组患者总切口长度、手术时间均短于手术组患者,术中出血量少于手术组患者,差异均有统计学意义(P﹤0.05)。消融组患者术后卧床时间、下肢恢复活动时间、住院时间均短于手术组患者,术后视觉模拟量表(VAS)评分低于手术组患者,差异均有统计学意义(P﹤0.05)。消融组患者术后并发症总发生率为5.56%(2/36),低于手术组患者的30.56%(11/36),差异有统计学意义(P﹤0.05)。术后6个月,两组患者慢性静脉功能不全问卷(CIVIQ)、生活质量核心量表(EORTC QLQ-C38)、自我效能评分均高于本组术前,静脉临床严重程度评分(VCSS)评分均低于本组术前,且消融组患者EORTC QLQ-C38、自我效能评分均高于手术组患者,差异均有统计学意义(P﹤0.05);术后6个月,两组患者VCSS、CIVIQ评分比较,差异均无统计学意义(P﹥0.05)。术后6个月,两组患者复发率、患肢色素沉着消退率、患肢浅表溃疡愈合率比较,差异均无统计学意义(P﹥0.05)。结论HLS与RFA治疗VVLE的疗效相当,但RFA创口小,术中出血量少,术后并发症少,恢复快,值得在临床上推广应用。Objective To investigate the efficacy of intracavitary radiofrequency ablation(RFA)and high ligation(HLS)in the treatment of varicose veins of lower extremity(VVLE).Method Clinical data of 72 VVLE patients admitted to the Zunyi Medical University Fifth Affiliated(Zhuhai)Hospital from January 2021 to June 2022 were collected and divided into operation group(n=36,treated with high ligation)and ablation group(n=36,treated with intracavity radio frequency ablation)according to different treatment methods.Postoperative recovery index and complication rate of surgical index in two groups were compared.After 6 months of follow-up,varicose veins,great saphenous vein function,quality of life,self-efficacy,recurrence rate and long-term efficacy were compared between the two groups.Result The total incision length and operation time in the ablation group were shorter than those in the surgery group,and the intraoperative blood loss was less than that in the surgery group,with statistical significance(P<0.05).Postoperative bed time,lower extremity recovery time and hospital stay in ablation group were all shorter than those in surgery group,and postoperative visual analogue scale(VAS)scores were lower than those in surgery group,with statistical significance(P<0.05).The total incidence of postoperative complications in the ablation group was 5.56%(2/36),lower than that in the surgery group of 30.56%(11/36),the difference was statistically significant(P<0.05).Six months after surgery,the chronic venous insufficiency questionnaire(CIVIQ),European organization for research and treatment of cancer quality of life questionnaire-colorectal 38(EORTC QLQ-C38)and self-efficacy scores of patients in both groups were higher than before surgery,and the venous clinical severity score(VCSS)scores were lower than before surgery,the EORTC QLQ-C38 and self-efficacy scores of patients in ablation group were higher than those in surgery group,the differences were statistically significant(P<0.05).Six months after surgery,there were no signific

关 键 词：下肢静脉曲张 疗效 高位结扎术 腔内射频消融术 

分 类 号：R543[医药卫生—心血管疾病]