泡沫硬化剂联合静脉旋切术治疗严重下肢静脉曲张的疗效观察
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摘要
目的探讨泡沫硬化剂联合静脉旋切术治疗严重下肢静脉曲张的临床疗效。方法收集2014年1月至2017年12月深圳大学第一附属医院(深圳市第二人民医院)共49例严重下肢静脉曲张(C4～C6级)患者,分为联合组(33例)和对照组(16例)。两组患者均先行大隐静脉高位结扎剥脱术,联合组采用泡沫硬化剂联合静脉旋切术,对照组则采用静脉旋切术。对两组术中出血量、术后疼痛时间、开始下床时间、住院时间、术后水肿发生率、其他并发症发生率进行比较。结果联合组与对照组在术中出血量、术后疼痛时间、住院时间上差异均有统计学意义(t=3.916、3.465、2.554,P=0.003、0.001、0.011),在术后下床时间、术后水肿发生率、术后并发症发生率上差异无统计学意义(t=1.851,χ~2=3.614、1.467,P=0.406、0.057、0.226)。结论泡沫硬化剂联合静脉旋切术具有出血量少、术后恢复时间快、住院时间短等优点,可个体化用于严重下肢静脉曲张的临床治疗。
Objective To investigate the clinical effect of combined treatment of the foam sclerotherapy and transilluminated powered phlebectomy(TIPP) of severe lower extremity varicose vein. Methods Forty-nine cases of varicosis of great saphenous vein were randomly divided into two groups: 33 cases in the combination group and 16 cases in the control group. The combination group underwent high ligation of great saphenous vein combined foam sclerotherapy and TIPP, while control group only high ligation of great saphenous vein combined TIPP. Results There were significant differences between two groups in intraoperative blood loss, postoperative pain duration and hospitalization duration(t=3.916, 3.465, 2.554, P=0.003, 0.001, 0.011), but no significant differences in postoperative off-bed time, postoperative edema incidence and postoperative complication incidence(t=1.851, χ~2=3.614, 1.467, P=0.406, 0.057, 0.226). Conclusion Foam sclerotherapy combined with TIPP shows less bleeding, postoperative recovery time, and shorter hospitalization time.
Objective To investigate the clinical effect of combined treatment of the foam sclerotherapy and transilluminated powered phlebectomy(TIPP) of severe lower extremity varicose vein. Methods Forty-nine cases of varicosis of great saphenous vein were randomly divided into two groups: 33 cases in the combination group and 16 cases in the control group. The combination group underwent high ligation of great saphenous vein combined foam sclerotherapy and TIPP, while control group only high ligation of great saphenous vein combined TIPP. Results There were significant differences between two groups in intraoperative blood loss, postoperative pain duration and hospitalization duration(t=3.916, 3.465, 2.554, P=0.003, 0.001, 0.011), but no significant differences in postoperative off-bed time, postoperative edema incidence and postoperative complication incidence(t=1.851, χ~2=3.614, 1.467, P=0.406, 0.057, 0.226). Conclusion Foam sclerotherapy combined with TIPP shows less bleeding, postoperative recovery time, and shorter hospitalization time.
引文
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[11]黄楷,陈钦昌,林细霞,等.高位结扎联合泡沫硬化剂治疗原发性大隐静脉曲张的初步疗效[J/CD].中华普通外科学文献(电子版), 2017, 11(6):422-425.
[12]金一琦,徐国雄,黄剑,等.大隐静脉主干高位结扎剥脱联合属支硬化剂治疗下肢静脉曲张[J].中国普通外科杂志, 2014,23(12):1721-1723.
[13]金志宏,高占峰,刘波,等.低速微创旋切术治疗下肢静脉曲张208例临床研究[J/CD].中华普外科手术学杂志(电子版),2011, 5(3):333-336.
[14]赵渝,刘洪.下肢静脉淤血性溃疡的诊断与治疗[J].临床外科杂志, 2014, 22(8):552-555.
[15]叶志东,樊雪强,陈洁,等.下肢静脉曲张治疗的现状及存在的问题[J].临床误诊误治, 2014, 27(3):73-76.
[2]万霞,刘建平.临床试验中的随机分组方法[J].中医杂志,2007, 48(3):216-219.
[3]吴权辉,林少芒,张智辉,等.泡沫硬化剂联合透光静脉旋切术治疗泡沫硬化剂联合透光静脉旋切术治疗下肢静脉曲张[J].广东医学, 2014, 35(7):1059-1062.
[4]许少鸿,万恒,林智琪,等.下肢静脉曲张的联合微创治疗[J].中国普通外科杂志, 2013, 22(12):1655-1658.
[5]Chen Qianyi, Fei Zhewei, Chen Dawei, et al. Comparative study of the efficacy of varicose vein in lower extremity treated by great saphenous vein high ligation combined with endovenous laser treatment and great saphenous vein high ligation and stripping[J].Chin J Vasc Surg(Electronic Version), 2013, 5(3):170-173.
[6]王深明.慢性原发性下肢静脉疾病微创治疗[J].临床外科杂志, 2013, 21(5):335-337.
[7]Marston WA, Carlin RE, Passman MA, et al. Healing rates and cost efficacy of outpatient compression treatment for leg ulcers associated with venous insufficiency[J]. J Vasc Surg, 1999, 30(3):491-498.
[8]俞慎林,乔正荣.大隐静脉曲张的微创治疗[J].山东医药,2005, 45(32):60-61.
[9]蒋米尔.下肢静脉曲张微创治疗进展[J].临床外科杂志, 2014,22(7):467-468, 474.
[10]殷恒讳,常光其,潘福顺,等.超声检测下泡沫硬化剂治疗重度以上下肢静脉曲张疗效分析[J/CD].中国血管外科杂志(电子版), 2012, 4(4):241-243.
[11]黄楷,陈钦昌,林细霞,等.高位结扎联合泡沫硬化剂治疗原发性大隐静脉曲张的初步疗效[J/CD].中华普通外科学文献(电子版), 2017, 11(6):422-425.
[12]金一琦,徐国雄,黄剑,等.大隐静脉主干高位结扎剥脱联合属支硬化剂治疗下肢静脉曲张[J].中国普通外科杂志, 2014,23(12):1721-1723.
[13]金志宏,高占峰,刘波,等.低速微创旋切术治疗下肢静脉曲张208例临床研究[J/CD].中华普外科手术学杂志(电子版),2011, 5(3):333-336.
[14]赵渝,刘洪.下肢静脉淤血性溃疡的诊断与治疗[J].临床外科杂志, 2014, 22(8):552-555.
[15]叶志东,樊雪强,陈洁,等.下肢静脉曲张治疗的现状及存在的问题[J].临床误诊误治, 2014, 27(3):73-76.