摘要
目的:对数字减影血管造影(DSA)引导下经导管注入聚桂醇泡沫硬化剂联合腔内激光闭合术治疗中度以上下肢静脉曲张的临床效果进行观察,探讨其可行性和安全性。方法:回顾性分析收治的参照临床-病因-解剖-病理生理(CEAP)分级的C4~C6的81例(145肢)下肢静脉曲张患者,均在硬膜外麻醉下行高位结扎大隐静脉主干及其属支,激光闭合大隐静脉主干,经大隐静脉在DSA引导下经造影导管注入聚桂醇泡沫硬化剂选择性闭塞曲张静脉。根据曲张静脉改善程度、临床症状以及不良反应等对治疗效果以及安全性进行评价。结果:在DSA引导下81例患者的145条患肢均成功注入泡沫硬化剂,平均注入16.7 ml/肢;42条患肢的溃疡均于术后6个月内愈合;随访12个月,痊愈患肢共计136肢,显效率达到93.8%,所有患者患肢曲张静脉消失且无复发,总有效率达到100%;4条患肢在术后3 d内并发浅静脉炎,经处理后好转;所有患者均未发生严重并发症及严重不良反应。结论:DSA引导下经导管注入聚桂醇泡沫硬化剂联合腔内激光闭合术治疗下肢静脉曲张,具有安全有效、创伤小、康复快、复发少等优点,是治疗下肢静脉曲张的理想方法。
Objective To evaluate the clinical effect and safety of the treatment of serious varicose of the lower extremity which treated with tile lauromacrogol foam sclerotherapy of digital subtraction angiography （DSA） guided combined with endovenous laser. Method The clinice data of 8I cases （145 legs） in vascular surgery with serious varicose of the lower extremity were retrospectively analyzed. According to the clinical etiological anatomical pathophysiological （CEAP） classification ,those patients were divided into CA- to C6. After high ligation of the peat saphenous vein and its tributaries in epidural anesthesia, endovenous laser closed the saphenous vein and DSA - guided foam sclerotherapy were performed using 4F catheter to inject the foam of lauromacrogol into lower extremity varicose to selectively block the great saphenous vein. Tile clinical effect and safety were evaluated by the degree of improvement varicose veins ,the clinical symptoms, and the adverse reactions. Results The procedure was technically successful for all the 81 cases （ 145 legs）. The average volume of injected sclero- sant were 16. 7/limb. All the ulcer were cured in six months after the surgery. All the patients were follow - up for 12 months ,the 136 limbs were cured （ 93.8% ） and the total effective rate was 100%. The varicose vein of all patients disappeared and had no recurrence. Phlebitis was observed in four cases in 3 days after the surgery, which was relieved after the treatment. There was no serious complications and ad- verse ceacrons. Conclusion The technology of DSA - guided lauromacrogol foam sclerotherapy combined with endovenous laser is a ideal way to treatment for serious varicose of the lower extremity with the advantages of safe, effective, less invasivc, faster recovery, less recur- rence.
出处
《吉林医学》
CAS
2014年第7期1380-1382,共3页
Jilin Medical Journal
基金
广东省医学科研基金立项[项目编号:A2012254]
关键词
静脉曲张
静脉腔内激光
泡沫硬化剂
数字减影血管造影
疗效
Varicose vein
Endovenous laser
Foam selerotherapy
Digital subtraction an^o~aphy
Clinical effect
