TriVex旋切术联合泡沫硬化剂注射在下肢静脉性溃疡治疗中的应用
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摘要
目的探讨TriVex旋切术联合泡沫硬化剂注射在治疗下肢静脉性溃疡中的效果。方法收集103例下肢静脉性溃疡患者,以传统手术治疗患者45例作为对照组,TriVex旋切术联合泡沫硬化剂注射治疗的患者58例作为观察组,采用美国静脉论坛国际专家特别委员会提出的CEAP静脉分类系统(clinical-etiology-anatomic-pathophysiologic classification system,CEAP)分级标准分级,所有患者均达到C6级诊断标准。比较两组患者手术时间、术中出血量、术后并发症、住院时间、疼痛评分(视觉模拟评分法VAS)及溃疡愈合时间等指标。结果两组患者手术时间、术中出血量、住院时间和疼痛评分方面差异有统计学意义(P<0.05),观察组更优;两组患者的溃疡愈合时间差异无统计学意义(P>0.05);术后深静脉血栓形成差异有统计学意义(P<0.05),观察组更低;肺栓塞和其他术后并发症比较差异无统计学意义(P>0.05)。结论采用TriVex旋切术联合泡沫硬化剂注射治疗下肢静脉性溃疡具有安全、有效、微创的治疗效果,具有临床应用意义。
引文
[1] 郭伟,符伟国,陈忠.卢瑟福血管外科学(上卷)[M].7版.北京:北京大学医学出版社,2013:824.
[2] 徐永波,禇海波,李坤,等.透光旋切术治疗下肢静脉曲张 225 例[J].中国现代普通外科进展,2010,13(3):237-239.
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[4] Lin SD,Cheng KH,Lin TM,et al.Management of the primary varicose veins with venous ulceration with assistance of endoscopic surgery[J].Ann Plast Surg,2006,56(3):289-294.
[5] 汪忠镐.汪忠镐血管外科学[M].杭州:浙江科学技术出版社,2010:1082.
[6] Scavee V,Theys S,Schoevaerdts JC.Transilluminated powered mini-phlebectomy:early clinical experience[J].Acta Chirur Belg,2001,101(5):247-249.
[7] Cheshire N,Elias SM,Keagy B,et al.Powered phlebectomy (TriVex) in treatment of varicose veins[J].Ann Vascu Surg,2002,16(4):488-494.
[8] Shamiyeh A,Schrenk P,Huber E,et al.Transilluminated powered phlebectomy:advantages and disadvantages of a new technique[J].Dermatol Surg,2003,29(6):616-619.
[9] Passman M.Transilluminated powered phlebectomy in the treatment of varicose veins[J].Vascular,2007,15(5):262-268.
[10] Franz RW,Knapp ED.Transilluminated powered phlebectomy surgery for varicose veins:a review of 339 consecutive patients[J].Ann Vasc Surg,2009,23(3):303-309.
[11] Spitz G.Transilluminated powered phlebectomy in an office setting:procedural considerations and clinical outcomes[J].J Endovasc Ther,2011,18(5):734-738.
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[13] Kim JW,Han JW,Jung SY,et al.Outcome of transilluminated powered phlebectomy for varicose vein:review of 299 patients (447 limbs)[J].Surg Today,2013,43(1):62-66.
[14] Lin PH,Matos JM,Chen A,et al.Treatment Outcomes and Lessons Learned From Transilluminated Powered Phlebectomy for Varicose Veins in 1034 Patients[J].Vasc Endovascular Surg,2016,50(4):277-282.
[15] Arumugasamy M,McGreal G,O′Connor A,et al.The technique of transilluminated powered phlebectomy——a novel,minimally invasive system for varicose vein surgery[J].Eur J Vasc Surg,2002,23(2):180-182.
[16] 郝立松,曹道白音,王青云,等.Trivex 旋切术治疗下肢静脉曲张 80 例临床分析[J].中国临床医生,2014,42(7):63-64.
[17] 邓武坚,李强,颜斐斐,等.大隐静脉高位结扎剥脱联合曲张静脉泡沫硬化剂注射及TriVex旋切术治疗下肢静脉曲张[J].现代诊断与治疗,2013,24(9):2081-2082.
[18] 王国胜,罗庚,江宏,等.TriVex透光旋切术与传统手术治疗下肢浅静脉曲张的对比研究[J].新医学,2018,49(2):109-112.
[19] 龙淼云,黎洪浩,彭新治,等.透光直视旋切术与腔镜深筋膜下结扎交通支静脉在静脉性溃疡治疗中的疗效比较研究[J].中国血管外科杂志:电子版,2012,4(3):166-168.
[20] 王忠福,赵渝,王学虎,等.以TriVex旋切术为中心的三阶段疗法治疗下肢静脉性溃疡的临床疗效观察[J].中华普通外科杂志,2014,29(4):257-260.
[21] 林少芒,张智辉,姚燕丹,等.腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全[J].中华外科杂志,2009,47(4):271-274.
[22] 朱永强.局部注射泡沫硬化剂治疗下肢静脉曲张、静脉性溃疡的基础和临床研究[D].苏州:苏州大学,2015.
[23] 张智辉,林少芒,李强,等.泡沫硬化剂注射治疗下肢慢性静脉功能不全[J].中国血管外科杂志:电子版,2012,4(2):105-107.
[24] 林树森,李喜春,杨钰杰.TriVex微创旋切术联合泡沫硬化剂注射治疗下肢静脉曲张的效果[J].中国老年学杂志,2015,35(12):3351-3352.
[2] 徐永波,禇海波,李坤,等.透光旋切术治疗下肢静脉曲张 225 例[J].中国现代普通外科进展,2010,13(3):237-239.
[3] Onida S,Lane TR,Davies AH.Improving the management of varicose veins[J].The Practitioner,2013,257(1766):21-4,2-3.
[4] Lin SD,Cheng KH,Lin TM,et al.Management of the primary varicose veins with venous ulceration with assistance of endoscopic surgery[J].Ann Plast Surg,2006,56(3):289-294.
[5] 汪忠镐.汪忠镐血管外科学[M].杭州:浙江科学技术出版社,2010:1082.
[6] Scavee V,Theys S,Schoevaerdts JC.Transilluminated powered mini-phlebectomy:early clinical experience[J].Acta Chirur Belg,2001,101(5):247-249.
[7] Cheshire N,Elias SM,Keagy B,et al.Powered phlebectomy (TriVex) in treatment of varicose veins[J].Ann Vascu Surg,2002,16(4):488-494.
[8] Shamiyeh A,Schrenk P,Huber E,et al.Transilluminated powered phlebectomy:advantages and disadvantages of a new technique[J].Dermatol Surg,2003,29(6):616-619.
[9] Passman M.Transilluminated powered phlebectomy in the treatment of varicose veins[J].Vascular,2007,15(5):262-268.
[10] Franz RW,Knapp ED.Transilluminated powered phlebectomy surgery for varicose veins:a review of 339 consecutive patients[J].Ann Vasc Surg,2009,23(3):303-309.
[11] Spitz G.Transilluminated powered phlebectomy in an office setting:procedural considerations and clinical outcomes[J].J Endovasc Ther,2011,18(5):734-738.
[12] Franz RW,Hartman JF,Wright ML.Treatment of varicose veins by transilluminated powered phlebectomy surgery:a 9-year experience[J].Int J Angiol,2012,21(4):201-208.
[13] Kim JW,Han JW,Jung SY,et al.Outcome of transilluminated powered phlebectomy for varicose vein:review of 299 patients (447 limbs)[J].Surg Today,2013,43(1):62-66.
[14] Lin PH,Matos JM,Chen A,et al.Treatment Outcomes and Lessons Learned From Transilluminated Powered Phlebectomy for Varicose Veins in 1034 Patients[J].Vasc Endovascular Surg,2016,50(4):277-282.
[15] Arumugasamy M,McGreal G,O′Connor A,et al.The technique of transilluminated powered phlebectomy——a novel,minimally invasive system for varicose vein surgery[J].Eur J Vasc Surg,2002,23(2):180-182.
[16] 郝立松,曹道白音,王青云,等.Trivex 旋切术治疗下肢静脉曲张 80 例临床分析[J].中国临床医生,2014,42(7):63-64.
[17] 邓武坚,李强,颜斐斐,等.大隐静脉高位结扎剥脱联合曲张静脉泡沫硬化剂注射及TriVex旋切术治疗下肢静脉曲张[J].现代诊断与治疗,2013,24(9):2081-2082.
[18] 王国胜,罗庚,江宏,等.TriVex透光旋切术与传统手术治疗下肢浅静脉曲张的对比研究[J].新医学,2018,49(2):109-112.
[19] 龙淼云,黎洪浩,彭新治,等.透光直视旋切术与腔镜深筋膜下结扎交通支静脉在静脉性溃疡治疗中的疗效比较研究[J].中国血管外科杂志:电子版,2012,4(3):166-168.
[20] 王忠福,赵渝,王学虎,等.以TriVex旋切术为中心的三阶段疗法治疗下肢静脉性溃疡的临床疗效观察[J].中华普通外科杂志,2014,29(4):257-260.
[21] 林少芒,张智辉,姚燕丹,等.腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全[J].中华外科杂志,2009,47(4):271-274.
[22] 朱永强.局部注射泡沫硬化剂治疗下肢静脉曲张、静脉性溃疡的基础和临床研究[D].苏州:苏州大学,2015.
[23] 张智辉,林少芒,李强,等.泡沫硬化剂注射治疗下肢慢性静脉功能不全[J].中国血管外科杂志:电子版,2012,4(2):105-107.
[24] 林树森,李喜春,杨钰杰.TriVex微创旋切术联合泡沫硬化剂注射治疗下肢静脉曲张的效果[J].中国老年学杂志,2015,35(12):3351-3352.