内压迫改良内翻抽剥与传统内翻抽剥术治疗大隐静脉曲张对比研究

A comparative study between modified invaginated stripping with compression inside and conventional invaginated stripping therapy for great saphenous vein varicosity

目的探讨内压迫改良内翻抽剥术治疗大隐静脉（GSV）曲张的效果、可行性及应用价值。方法选择2011年6月～2013年1月温州医科大学附属第三医院收治的单纯性GSV曲张患者230例．随机分为观察组（115例）和对照组（115例）。观察组采用内压迫改良内翻抽剥＋点状抽剥术；对照组采用传统大隐静脉内翻剥脱＋点状抽剥术。观察GSV一次抽剥成功率、手术时间、术中出血量、首次下床活动时间、术后皮下出血、术后VAS疼痛评分、深静脉血栓形成、隐神经损伤、复发率情况。结果观察组GSV一次抽剥成功率高于对照组（P〈0．01），手术时间、首次下床活动时间明显短于对照组（P〈0．01），术中失血量、术后皮下出血明显少于对照组（P〈0．01），术后VAS疼痛评分低于对照组（P〈0．01）。两组深静脉血栓形成、隐神经损伤、复发率等术后并发症比较差异无统计学意义（P〉0．05）。结论内压迫改良内翻抽剥术治疗GSV曲张临床优势明显，值得临床应用推广。

Objective To explore the effect, feasibility and application value of modified invaginated stripping with compression inside in the treatment of great saphenous vein （GSV） varicosity. Methods 230 cases with primary GSV varicosity treated in the Third Affiliated Hospital of Wenzhou Medical University from June 2011 to January 2013 were recruited and randomly divided into the observation group （n=115） and the control group （n=115）. The observation group was treated with the modified invaginated stripping with compression inside combined with pointed phlebectomy. The control group was treated with conventional invaginated stripping combined with pointed phlebectomy. One time success rate of GSV stripping, operating time, amount of bleeding during operation, first ambulation time, subcutaneous hemorrhage after operation, postoperative VAS pain score, deep venous thrombosis, saphenous nerve injury and recur- rence rate were assessed. Results Compared with the control group, the observation group had a higher one time suc- cess rate of GSV stripping （P 〈 0.01）, shorter operating time and earlier first ambulation time （P 〈 0.01）, less amount of bleeding during operation and subcutaneous hemorrhage after operation （P 〈 0.01）, and lower postoperative VAS pain score （P 〈 0.01）. The deep venous thrombosis, saphenous nerve injury and recurrence rate between the two groups had no significant differences （P 〉 0.05）. Conclusion The modified invaginated stripping with compression inside therapy for GSV varicosity has better clinical effects. It is worthy of clinical promotion.