摘要
目的探讨高位结扎联合泡沫硬化剂治疗原发性大隐静脉曲张的临床效果。方法收集2016年1月至12月中山大学孙逸仙纪念医院的病例60例,按大隐静脉主干的处理方式分成两组:主干硬化剂组共26例,30条患肢;剥脱组共34例,共37条患肢。记录2组患者手术方式、手术时间、小腿部硬化剂用量,术后于站立位静脉曲张的复通率和局部不良反应(局部皮肤坏死、溃疡)。结果在大腿部位的大隐静脉主干应用3%泡沫硬化剂,硬化剂组显示手术时间和住院时间较剥脱组明显的缩短,差异有统计学意义[(50.41±2.12)min vs(59.73±1.47)min,(1.96±0.11)d vs(4.53±1.07)d,t=22.862、12.221,均P<0.001],并且小腿曲张静脉1%泡沫硬化剂用量显著减少[(3.53±0.31)ml vs(5.84±0.31)ml,t=28.425,P<0.01]。2组在一期复通率、浅静脉炎及色素沉着的并发症发生率上,差异没有统计学意义。结论高位结扎联合3%泡沫硬化剂治疗原发性大隐静脉曲张的疗效稳定且可靠,安全而且操作更为简洁、微创,在一定恢复时期内可以恢复下肢的美容状态,更符合快速康复医学理念,是可以推广的一种手术方式。
Objective To discuss the clinical effect on primary great saphenous varicose veins of the combination therapy of high ligation and foam sclerotherapy. Methods Sixty cases were collected from January to December 2016 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University, and were divided into two groups according to the treatment of great saphenous vein trunk： Group foam sclerotherapy, 26 cases with 30 limbs; Group vein stripped, 34 cases with 37 limbs. Operation time and methods, the volume of foam sclerosing agent consumed were recorded, as well as the recanalization rate of varicose veins in standing position, and the local reactions （including local skin necrosis and ulcer）. Results 3% foam sclerosing agent was applicated on the great saphenous vein trunk. the operation time and length of hospital stay in group foam sclerotherapy was significantly shorter, with statistical difference[（50.4±2.12） min vs （59.73±1.47） min, （1.96±0.11） d vs （4.53±1.07） d, t=22.862, 12.221, P〈0.001]. The volume of 1% foam sclerosing agent consumed in the leg was reduced, which showed statistical difference[（3.53±0.31） ml vs （5.84±0.31） ml, t=28.425, P〈0.01]. However, the recanalization rate and the incidence of phlebitis and pigmentation showed no statistically significant difference between the two groups. Conclusion The clinical effect of the combination therapy of high ligation and foam sclerotherapy on primary great saphenous varicose veins is minimally invasive, stable and reliable, safe, simple and cosmetic, which is worthy of rapid rehabilitation medicine concept and promotion.
出处
《中华普通外科学文献（电子版）》
2017年第6期422-425,共4页
Chinese Archives of General Surgery(Electronic Edition)
基金
广东省自然科学基金资助项目(2015A030310346)
关键词
隐静脉
静脉曲张
结扎术
泡沫硬化剂
Saphenous veins
Varicose veins
Ligation
Foam sclerotherapy
