目的探讨腔内射频消融术(RFA)治疗下肢浅静脉曲张的临床疗效。方法回顾性分析216例(236肢)下肢浅静脉曲张患者的临床资料,将行腔内RFA和大隐静脉高位结扎剥脱术治疗的患者分别设为观察组(106例)和对照组(110例)。比较两组患者手术时间...目的探讨腔内射频消融术(RFA)治疗下肢浅静脉曲张的临床疗效。方法回顾性分析216例(236肢)下肢浅静脉曲张患者的临床资料,将行腔内RFA和大隐静脉高位结扎剥脱术治疗的患者分别设为观察组(106例)和对照组(110例)。比较两组患者手术时间、术中出血量、术后住院时间、术后24 h VAS评分和术后并发症情况,以及手术前后的CEAP分级、静脉临床严重程度评分(VCSS)、慢性静脉功能不全问卷(CIVIQ)评分情况。结果与对照组相比,观察组患者术中出血量少、术后住院时间短、术后24 h VAS评分低、并发症发生率低(均P<0.05),但两组手术时间差异无统计学意义(P>0.05)。术后1年,两组患者术后CEAP分级优于术前,VCSS低于术前,CIVIQ评分高于术前(均P<0.05),但两组比较差异均无统计学意义(均P>0.05);术后3个月,两组CIVIQ评分高于术前,且观察组评分高于对照组(均P<0.05)。结论腔内RFA治疗下肢浅静脉曲张患者,方法更简单、微创,并发症更少,围术期患者的体验更好,生活质量改善较好。展开更多
BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)...BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)and conventional surgery were retrospective and observational in nature and the results may therefore have been influenced by selection bias and the presence of other confounding factors.In this study,we used propensity score matching to reduce selection bias when comparing EVLT and conventional surgery for the treatment of varicose great saphenous veins.METHODS We retrospectively reviewed the records of 1063 patients treated for primary varicosis of the great saphenous vein at the Second Affiliated Hospital of Xuzhou Medical University between January 2009 and December 2019.Among them,56 patients were excluded owing to additional small saphenous varicose vein involvement,81 owing to recurring varicose veins,83 owing to complicated varicose veins(CEAP clinical classification C5-C6),and 6 owing to perioperative phlebitis.Finally,772 patients were enrolled in this study.Standard demographic and clinicopathological data were collected from the medical records of the patients.For propensity score matching,522 patients(261 who underwent EVLT and 261 who underwent conventional surgery)were randomly matched 1:1 by age,sex,onset time,smoking status,presence of diabetes,family history,stress therapy,C class,and the affected leg.RESULTS Of the 772 patients included in the study,467 underwent EVLT and 305 underwent conventional surgery.There were significant differences in age,onset time,smoking and diabetes status,and family history between the two groups.Following propensity score matching,no significant differences in patients’characteristics remained between the two groups.ELVT was associated with a shorter operation time and hospital stay than conventional surgery,both before and after propensity score matching.There were no differences in complications between the two groups after propensity score match展开更多
文摘目的探讨腔内射频消融术(RFA)治疗下肢浅静脉曲张的临床疗效。方法回顾性分析216例(236肢)下肢浅静脉曲张患者的临床资料,将行腔内RFA和大隐静脉高位结扎剥脱术治疗的患者分别设为观察组(106例)和对照组(110例)。比较两组患者手术时间、术中出血量、术后住院时间、术后24 h VAS评分和术后并发症情况,以及手术前后的CEAP分级、静脉临床严重程度评分(VCSS)、慢性静脉功能不全问卷(CIVIQ)评分情况。结果与对照组相比,观察组患者术中出血量少、术后住院时间短、术后24 h VAS评分低、并发症发生率低(均P<0.05),但两组手术时间差异无统计学意义(P>0.05)。术后1年,两组患者术后CEAP分级优于术前,VCSS低于术前,CIVIQ评分高于术前(均P<0.05),但两组比较差异均无统计学意义(均P>0.05);术后3个月,两组CIVIQ评分高于术前,且观察组评分高于对照组(均P<0.05)。结论腔内RFA治疗下肢浅静脉曲张患者,方法更简单、微创,并发症更少,围术期患者的体验更好,生活质量改善较好。
基金the Excellent Talents Fund Project of Xuzhou Medical University,No.XYFY2021019.
文摘BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)and conventional surgery were retrospective and observational in nature and the results may therefore have been influenced by selection bias and the presence of other confounding factors.In this study,we used propensity score matching to reduce selection bias when comparing EVLT and conventional surgery for the treatment of varicose great saphenous veins.METHODS We retrospectively reviewed the records of 1063 patients treated for primary varicosis of the great saphenous vein at the Second Affiliated Hospital of Xuzhou Medical University between January 2009 and December 2019.Among them,56 patients were excluded owing to additional small saphenous varicose vein involvement,81 owing to recurring varicose veins,83 owing to complicated varicose veins(CEAP clinical classification C5-C6),and 6 owing to perioperative phlebitis.Finally,772 patients were enrolled in this study.Standard demographic and clinicopathological data were collected from the medical records of the patients.For propensity score matching,522 patients(261 who underwent EVLT and 261 who underwent conventional surgery)were randomly matched 1:1 by age,sex,onset time,smoking status,presence of diabetes,family history,stress therapy,C class,and the affected leg.RESULTS Of the 772 patients included in the study,467 underwent EVLT and 305 underwent conventional surgery.There were significant differences in age,onset time,smoking and diabetes status,and family history between the two groups.Following propensity score matching,no significant differences in patients’characteristics remained between the two groups.ELVT was associated with a shorter operation time and hospital stay than conventional surgery,both before and after propensity score matching.There were no differences in complications between the two groups after propensity score match
