顺行与逆行内翻抽剥治疗大隐静脉曲张的临床效果比较

Efficacy comparison of anterograde and retrograde invagination stripping in treatment of great saphenous varicose veins

目的:比较顺行与逆行内翻抽剥治疗大隐静脉曲张的临床效果。方法:回顾分析511例行内翻抽剥加点式抽剥治疗静脉曲张患者的临床资料,其中234例行从内踝附近开始至隐股交界处方向的顺行抽剥(顺行组),277例行从隐股交界处开始至内踝附近方向的逆行抽剥(逆行组),比较两组患者的相关临床指标。结果:两组患者术前资料具有可比性。两组的手术时间、术中出血量、切口个数、术后住院时间、总并发症发生率、术后下肢酸胀情况及术后溃疡愈合时间方面,差异均无统计学意义(均P>0.05),但顺行组隐神经损伤率及术后静脉曲张复发率明显低于逆行组(P<0.05)。结论:顺行抽剥治疗大隐静脉曲张在减少隐神经损伤和远期疗效方面优于逆行抽剥。

Objective： To compare the clinical effects of anterograde and retrograde invagination stripping for great saphenous varicose veins. Methods： The clinical data of 511 patients undergoing invagination stripping plus dot stripping for great saphenous varicose veins were retrospectively analyzed. Of the patients, 234 cases underwent stripping in an anterograde direction from the themedial malleolar region toward the saphenofemoral junction （anterograde stripping group） and 277 cases underwent stripping in a retrograde direction from the saphenofemoral junction toward the themedial malleolar region （retrograde stripping group）. The main clinical variables between the two groups of patients were compared. Results： The preoperative data of the two groups of patients were comparable. There were no statistically significant differences in aspects of operative time, intraoperative blood loss, number of incisions, length of postoperative hospital stay, overall incidence of complications, postoperative leg acid bilges and ulcer healing time between the two groups （all P〉0.05）, but the incidence of saphenous nerve injury in the anterograde group recurrence rate of varicose veins in retrograde group in anterograde stripping group were significantly lower than those in retrograde stripping group （both P〈0.05）. Conclusion： For great saphenous varicose veins, anterograde stripping is superior to retrograde stripping in terms of reducing saphenous nerve injury and long-term efficacy.