摘要
目的比较大隐静脉曲张的两种主要治疗方式高位结扎剥脱术（HL/S）和静脉激光烧灼术（EVLA）的疗效。方法根据Meta分析报告标准（PRISMA声明）,检索建库至2014年11月Pub Med、EMBASE、CENTRAL、中国生物医学文献服务系统（Sino Med）中采用高位结扎剥脱术和静脉激光烧灼术治疗大隐静脉曲张的文献,依据纳入排除标准对文献进行筛选,采用Epidata 3.1软件进行数据提取,采用Rev Man 5.2软件进行Meta分析。结果最终共7篇随机对照研究文献纳入本研究,均为英文文献,共包括1402例患者、1455条患肢。Meta分析结果显示,高位结扎剥脱术和静脉激光烧灼术治疗大隐静脉曲张的技术成功率分别为98.5%和98.4%,OR值为1.06（95%CI 0.45～2.52,P=0.89）,远期复发率分别为15.8%和15.5%,OR值为1.11（95%CI 0.18～1.52,P=0.53）,远期反流率分别为12.5%和为15.7%,OR值为0.65（95%CI0.34～1.22,P=0.18）,术后远期阿伯丁静脉曲张症状严重程度评分（AVVSS）平均差为0.17（95%CI–0.63～0.96,P=0.68）。结论高位结扎剥脱术和静脉激光烧灼术治疗大隐静脉曲张的技术成功率、远期复发率、远期反流率、术后远期AVVSS等均无明显差异,二者均是治疗大隐静脉曲张的合适术式。
Objective Varicosis of great saphenous vein has a gradually increased morbidity rate in the troop. We conducted a meta-analysis of the result of two main treatment modalities, namely EVL A（endovenous laser ablation） and HL/S（high ligation with stripping）, in order to provide a better reference for the surgical option. Methods Literature published before November 2014 was selected and screened on the basis of inclusion and exclusion criteria for PRISMA statement（preferred reporting items for systematic reviews and meta-analyses）, and Epidata（3.1 version） were used for data extraction and Rev Man（5.2 version） used for meta-analysis. Results A total of seven randomized controlled trials in patients with 1402 cases involving 1455 legs were included in this study. Meta-analysis indicated that： technical success rate was 98.5% and 98.4% for HL/S and EVLA, respectively and OR was 1.06（95% CI 0.45-2.52）, P=0.89; long-term recurrence rate was 15.8% in HL/S and 15.5% in EVLA, OR1.11（95% CI 0.18-1.52）, P=0.53; long-term reflux rate was 12.5% for HL/S and 15.7% for EVLA, OR 0.65（95% CI 0.34-1.22）, P=0.18. The mean difference of AVVSS（Aberdeen Varicose Vein Symptoms Severity Score） was 0.17（95% CI-0.63-0.96）, P=0.68. Conclusion There is no significant difference between EVLA and HL/S in the success rate, long-term recurrence rate, long-term reflux rate, and long-term postoperative AVVSS, and both treatment modalities could be the appropriate option for the treatment of varicosity of great saphenous vein.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2015年第9期763-768,共6页
Medical Journal of Chinese People's Liberation Army
关键词
静脉曲张
血管外科手术
随机对照试验
META分析
varicose veins
vascular surgical procedures
randomized controlled trial
Meta-analysis
