摘要
目的 引入倾向性评分匹配法（PSM）比较单纯腔内激光治疗（EVLT）与EVLT联合经皮连续环形缝扎术（PCCS）治疗大隐静脉曲张术后的复发率。方法 回顾性分析2009－2014年我院收治的170例大隐静脉曲张患者的临床资料，其中单纯接受EVLT的患者87例（EVLT组），EVLT联合PCCS的患者83例（EVLT＋PCCS组）。使用SPSS软件的PSM功能对两组采用1：1最邻近匹配法，得到组间协变量均衡的样本。采用Kaplan-Meier法评估两组患者再复发率，组间比较采用Log-rank检验。结果 两组匹配成功各67例，匹配后的两组患者基本临床资料无明显差异。匹配前，EVLT组1、2、3年的累计复发率为3.5%、5.4%和7.3%，EVLT＋PCCS组为0.9%、4.7%和4.7%，经Log-rank检验两组患者再复发率无明显差异（P＝0.491）；PSM后，EVLT组1、3、5年的累计复发率为5.2%、5.2%和7.1%，EVLT＋PCCS组为0、1.0%和1.0%，经Log-rank检验，差异存在统计学差异（P＝0.031）。 结论 应用PSM可以有效地均衡非随机研究组间的协变量；EVLT联合PCCS可有效降低大隐静脉曲张术后的复发率。
Objective To compare the difference in recurrence rates between the endovenous laser therapy（EVLT） combined with percutaneous continuous circumsuture（PCCS） and simplex EVLT following the treatment of great saphanous vein incompetence through the introduction of propensity score matching（PSM）.Methods T the baseline data of 170 patients diagnosed with great saphanous vein incompetence who were treated in Punan Hospital in Pudong New District of Shanghai from 2009 to 2014 were retrospectively analyzed, of which underwent EVLT were 87 cases as EVLT group and EVLT combined with PCCS were 83 cases as EVLT＋ PCCS group.The groups covariate were balanced based on the PSM function of SPSS software using 1： 1 nearest neighbor matching method.The recurrence rates of the two groups were estimated by Kaplan-Meier method and the differences between the two groups were evaluated by Log-rank test.Results Sixty-seven pairs of patients were successfully matched.No significant difference between the two matched groups in the basic clinical features.Before PSM, the 1, 2, and 3 year cummulative recurrence rates were 3.5%, 5.4% and 7.3% in the EVLT group, and 0.9%, 4.7% and 4.7% in the EVLT＋ PCCS group, respectively, there were no statistically significant differences between the two groups by Log-rank test（P=0.491）. After PSM, the 1, 2, and 3 year cummulative recurrence rates were 5.2%, 5.2% and 7.1% in the EVLT group, and 0%, 1.0% and 1.0% in the EVLT＋ PCCS group, there were statistically significant differences between the two groups（P=0.031）.Conclusion The PSM methods can effectively balanced the covariates of groups in non-randomised study.EVLT combined with PCCS can effectively reduce the recurrence rate after the treatment of great saphanous vein incompetence.
作者
陶国强
章彬
曹明华
司云飞
汪加宽
韩琪
吴金秀
Tao Guoqiang Zhang Bin Cao Minghua Si Yunfei Wang Jiakuan Han Qi Wu Jinxiu(General Surgery Department, Punan Hospital in Pudong New District of Shanghai, Shanghai 200125, China)
出处
《中国综合临床》
2017年第1期7-10,共4页
Clinical Medicine of China
基金
上海市卫生和计划生育委员会科研课题（201540409）
关键词
大隐静脉曲张
腔内激光治疗
经皮连续环形缝扎术
倾向性评分匹配
复发率
Great saphanous vein incompetence
Endovenous laser therapy
Percutaneouscontinuous circumsuture
Propensity score matching
Recurrence rate
