大隐静脉高位结扎联合导管泡沫硬化剂治疗下肢静脉曲张

High ligation of great saphenous vein combined with catheter foam sclcrotherapy in varicose veins

目的观察大隐静脉高位结扎联合数字减影血管造影(DSA)导管引导下的泡沫硬化剂治疗下肢静脉曲张的临床疗效。方法选取本院2012年10月至2013年4月下肢静脉曲张患者26例(26条患肢),大隐静脉高位结扎并在DSA导管引导下对患肢大隐静脉主干内注射1%聚桂醇泡沫硬化剂,观察大隐静脉主干的闭合情况。结果患者均在DSA导管引导下成功注射1%聚桂醇泡沫硬化剂,平均每条患肢应用26.5ml泡沫硬化剂。24例大隐静脉主干治疗后即可见反流消失。治疗2周及3个月后随诊下肢静脉超声示大隐静脉主干闭塞。患者下肢活动后酸胀、乏力感消失,大隐静脉走形迂曲、扩张、畸形静脉消失,无严重并发症发生。结论大隐静脉高位结扎联合DSA导管引导下泡沫硬化剂疗法是一种安全、有效、微创治疗大隐静脉曲张的方法,但其远期效果仍然需要进行进一步的随访观察。

Objective To evaluate the efficacy of the digital subtraction angiography(DSA)-guided transcatheter foam sclerotherapy combined with high ligation of great saphenous vein in varicose veins. Methods Between October 2012 and April 2013, the clinical data of 26 patients(26 limbs in total) with varicose veins were retrospectively reviewed. All of the patients received DSA-guided transcatheter foam sclerotherapy combined with high ligation of great saphenous vein. The closure condition of the great saphenous vein was observed. Results 1% lauromacrogol was successfully injected in all patients. The average volume of foam sclerosant was 26.5ml for each limb. Great saphenous vein reflux disappeared in 24 cases after treatment. Great saphenous vein occlusion was confirmed by ultrasonography 2 weeks and 3 months after therapy. Activity soreness, fatigue and tortuous, expansion, deformity of vein disappeared. No serious complications occurred. Conclusion DSA-guided transcatheter foam sclerotherapy combined with high ligation of great saphenous vein is a safe, effective and minimally invasive treatment of great saphenous varicose veins. However, the longterm result needs to be verified in the future.