不同术式治疗慢性下肢静脉功能不全术后生活质量分析

Analysis of Quality of Life of Patients with Chronic Lower Extremity Venous Insufficiency Treated by Different Operation

目的比较不同术式治疗慢性下肢静脉功能不全的疗效及对患者生活质量影响。方法方便选取2015年1月—2016年1月期间在该院收治的慢性下肢静脉功能不全患者164例,根据术式不同分为3组,分别为A组:全程剥脱组;B组:全程激光组;C组:膝上剥脱+膝下激光组。采取模拟视觉疼痛(VAS)评分法和慢性静脉功能不全调查表(CIVIQ)调查表评定术后疼痛及术后3个月、6个月及1年的生活质量,并随访观察复发情况。结果A组疼痛VAS评分(2.30±0.986)分高于B组(1.49±0.635)分及C组(1.68±0.692)分,组间对比差异有统计学意义(P<0.05),但B组与C组术后VAS评分差异无统计学意义(P>0.05)。术后3月,A组CIVIQ评分(76.63±6.862)分低于B组(81.62±7.392)分及C组(80.73±5.525)分,差异有统计学意义(P<0.05),但B组与C组组间差异无统计学意义(P>0.05),术后6月及术后1年各组CIVIQ评分均满意,各组间比较差异于统计学意义(P>0.05),各组随访1年均未发现复发。结论对慢性下肢静脉功能不全采用不同手术方式,均能获得满意的远期生活质量,减少对膝下浅静脉的剥脱而采用激光,具有减轻术后疼痛,加快术后康复,快速提升生活质量的积极意义。

Objective This paper tries to compare the efficacy of different surgical procedures in the treatment of chronic lower extremity venous insufficiency and the effect on quality of life. Methods 164 cases of chronic venous function in the hospital from January 2015 to January 2016 were convenient selected and were divided into three groups, group A： full stripping group; group B： the whole laser group; group C： knee knee stripping ＋ laser group. The simulated visual pain（VAS） score and the chronic venous insufficiency questionnaire（CIVIQ） questionnaire were used to assess the postoperative pain and the quality of life of three months, six months and one year after operation, and the recurrence was observed. Results The VAS score of group A was higher than that of group B and group C[（2.30±0.986）points;（1.49±0.635）points;（1.68±0.692）points,（P〈0.05）], but there was no significant difference between group B and group C（P〉0.05）. The CIVIQ scores in group A were significantly lower than those in group B and group C of 3 months after operation（Group A,（76.63 ±6.862）points; Group B,（81.62±7.392）points; Group C,（80.73±5.525）points;（P〈0.05）, but there was no significant difference between group B and group C（P〉0.05）. However, there was no significant difference after 6 months and 1 year（P〉0.05）. No recurrence was found in each group for one year. Conclusion It is possible to obtain satisfactory long-term quality of life by using different surgical methods for chronic lower extremity venous insufficiency. Reducing the use of stripping great saphenous vein below-knee and instead of laser can reduce postoperative pain, accelerate postoperative rehabilitation and improve the quality of life.