摘要
目的评价改良大隐静脉高位结扎加抽剥术联合泡沫硬化剂注射治疗下肢静脉曲张的临床疗效。方法收集2017年1月至2019年12月于北京积水潭医院行手术治疗的200例下肢静脉曲张患者的临床资料,按照手术方式不同将患者分为观察组(n=104,接受改良大隐静脉高位结扎加抽剥术联合泡沫硬化剂注射治疗)和对照组(n=96,接受改良大隐静脉高位结扎加抽剥术及点式剥脱术)。比较两组患者的手术情况,包括手术时间和术后并发症发生情况。观察两组患者术后1个月内并发症的发生情况,包括肢体肿胀、下肢深静脉血栓形成、皮下血肿、创口感染、皮肤感觉障碍。观察两组患者术后1年静脉曲张的复发情况和皮肤感觉障碍的发生情况。结果观察组患者的手术时间明显短于对照组患者,差异有统计学意义(P<0.01)。观察组患者术后皮肤感觉障碍的发生率低于对照组患者,差异有统计学意义(P<0.05)。术后1个月内,两组患者肢体肿胀、皮下血肿、创口感染的发生率比较,差异均无统计学意义(P>0.05)。两组患者术后均未发生下肢深静脉血栓形成。两组患者术后1年静脉曲张复发率和皮肤感觉障碍发生率比较,差异均无统计学意义(P>0.05)。结论对于下肢静脉曲张患者,改良大隐静脉高位结扎加抽剥术联合泡沫硬化剂注射治疗安全有效,具有创伤小、手术时间短、神经损伤少等优点,值得临床推广应用。
Objective To evaluate the clinical effect of modified great saphenous vein high ligation and stripping combined foam sclerosing in the treatment of lower extremity varicosis.Method Clinical data of 200 patients with lower extremity varicosis who underwent surgical treatment in Beijing Jishuitan Hospital from January 2017 to December 2019 were collected.According to the operation method,the patients were divided into the observation group(n=104,treated with modified great saphenous vein high ligation and stripping+foam sclerotherapy)and the control group(n=96,treated with modified great saphenous vein high ligation and stripping+venous mass point stripping).General operation condition including operation time and postoperative complications was compared between two groups.The complications including including limb swelling,deep venous thrombosis of lower extremity,subcutaneous hematoma,wound infection,and skin sensory dysfunction were observed within 1 month after operation.The residual skin sensory dysfunction and recurrence of varicose veins at 1 year after operation were compared between the two groups.Result The operation time of the observation group was significantly lower than that of the control group(P<0.01);the occurrence of postoperative skin sensory dysfunction in the observation group was lower than that of control group(P<0.05).Within one month after operation,there was no significant difference for limb swelling,subcutaneous hematoma,and wound infection(P>0.05).There was no deep venous thrombosis of lower extremity in both groups.After 1 year of follow-up,there was no statistical difference for the recurrence of varicose veins and residual skin sensory dysfunction between the two groups(P>0.05).Conclusion Modified great saphenous vein high ligation and stripping+foam sclerotherapy is safe and effective for patients with lower extremity varicosis,which has the advantages of minimal invasion,shorter operation time,and less nerve damage,and is worthy of clinical application.
作者
蒋鹏
刘建龙
李金勇
贾伟
田轩
程志远
张蕴鑫
刘笑
田晨阳
Jiang Peng;Liu Jianlong;Li Jinyong;Jia Wei;Tian Xuan;Cheng Zhiyuan;Zhang Yunxin;Liu Xiao;Tian Chenyang(Department of Vascular Surgery,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《血管与腔内血管外科杂志》
2022年第5期513-516,553,共5页
Journal of Vascular and Endovascular Surgery
关键词
下肢
静脉曲张
大隐静脉高位结扎术
抽剥术
泡沫硬化剂
临床疗效
lower extremity
varicosis
great saphenous vein high ligation
stripping
foam sclerotherapy
clinical effect
