高位结扎联合血管内激光治疗大隐静脉曲张的临床疗效分析

马兵兵，夏晓娜，许群涛，但昭强，党涛平，杨滏宁

（1.兵器工业521 医院，陕西西安，710065；2.西安交通大学第一附属医院，陕西西安，710065）

浏览次数：126次 下载次数：281次

摘要：

目的 分析探讨高位结扎联合血管腔内激光治疗大隐静脉曲张的疗效。方法 回顾分析我科收治的105例原发性大隐静脉曲张患者资料，分组采用传统大隐静脉高位结扎剥脱(传统组)、高位结扎联合血管腔内激光治疗(激光组)，其中传统组50例(78侧患肢);激光组55例(74侧患肢)。比较两组手术耗时、手术中出血量、患侧肢体切口数、术后对疼痛的评分、术后住院天数和术后并发症发生情况。结果 在手术时间、术中出血量、患肢切口数、术后疼痛评分及术后住院天数等方面，激光组各指标均优于传统组，差异有统计学意义(P<0.05);激光组术后各并发症发生率低于传统组(P<0.05)。结论 大隐静脉高位结扎联合血管腔内激光手术在治疗下肢静脉曲张中具有手术创伤小、术后恢复快、疗效好、安全性较高、患肢美观等优点，值得推广。

关键词：下肢静脉曲张；大隐静脉；静脉腔内激光手术；大隐静脉高位结扎剥脱术

中图分类号：R654.4文献标志码：A文章编号：2096-1413(2017)07-0014-03

The clinical curative effect analysis of high ligation combined with endovascular laser treatment on great saphenous varicose veins

MA Bing-bing, XIA Xiao-na, XU Qun-tao, DAN Zhao-qian, DANG Tao-ping, YANG Fu-ning

(1. Ordnance Industry 521 Hospital, Xi’an 710065; 2. the First Affiliated Hospital of Xi’anJiaotongUniversity, Xi’an710065,China)

ABSTRACT: Objective To explore the curative effect of high ligation combined with endovascular laser on great saphenous varicose veins. Methods One hundred and five cases of patients with great saphenous varicose veins in our department were retrospectively analyzed and randomly divided into two groups, and adopted the traditional great saphenous vein high ligation peeling (traditional group) and high ligation combined endovascular laser treatment (laser group) respectively. The traditional group included 50 cases (78 sides limb), while the laser group included 55 cases (74 sides limb). The operation time, intraoperative blood loss, number of limb incision, postoperative pain score, postoperative hospitalization days, postoperative complications were compared between the two groups. Results The operative time,intraoperative blood loss, number of limb incision, postoperative pain score and postoperative hospitalization days in laser group were significantly superior to those in the traditional group (P<0.05); the incidence rate of postoperative complications in laser group was significantly less than that in the traditional group (P<0.05). Conclusion High ligation combined with endovascular laser treatment in the treatment of lower extremity varicosities has a significant curative effect, with small surgical trauma, quick recovery, high security, limb beauty, which is worthy of clinical popularization.

KEYWORDS:varixoflowerlimb;greatsaphenousveins;endovenouslasertreatment;greatsaphenousveinhighligationstripped

参考文献：

[1] GLOVICZKI P,COMEROTA AJ,DALSING MC,et al.The care of pa-tients with varicose veins and associated chronic venous diseases: clini-calpractice guidelines of the socienty for vascular surgery and the Amer-ican venous forum[J].J Vasc Surg,2011,53(5 Suppl):2S-48S.

[2] 高万露,汪小海.患者疼痛评分法的术前选择及术后疼痛评估的效果分析[J].实用医学杂志,2013,29(23):3892-3894.

[3] 林少芒.下肢静脉疾病的诊治现状[J].中国血管外科杂志:电子版,2012,4(1):8-9.

[4] WOZNIAK W,MLOSEK RK,CIOSTEK P.Assessment of the efficacy and safety of steam vein sclerosis as compared to classic surgery in lower extremity varicose vein management[J].Videosurg Other Miniinvas Tech,2015,10(1):15-24.

[5] FINDIK O,AYDIN U,DTIZYOL C,et a1.An extremely rare complica-tion of varicose vein surgery: retmned foreign body[J].Case RepSurg,2014,20(5):1-2.

[6] CARRADIEE D,MEKAKO AI,MAZARI FAK,et a1.Clinical and technical outcomes from a randorllized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous vari-cose veins[J].Br J Surg,2011(98):1117-1123.

[7] 陈千益,费哲为,陈大伟,等.激光腔内闭合联合高位结扎与大隐静脉高位结扎剥脱术治疗下肢静脉曲张的疗效比较[J].中国血管外科杂志:电子版,2013,5(3):170-173.

[8] 钱利强,高泉根,沈根海,等.两种手术方法治疗大隐静脉曲张的临床对比研究[J].中国现代普通外科进展,2015,18(4):317-319.