点式剥脱术结合射频消融治疗大隐静脉曲张的临床效果研究

Clinical effect of punctate stripping combined with endovenous laser ablation in the treatment of great saphenous varicose veins

目的:探讨点式剥脱术结合射频消融在大隐静脉曲张治疗方面的临床效果。方法:选取2021年9月至2022年9月本院收治的86例大隐静脉曲张患者作为研究对象,随机分为观察组和对照组,各43例。对照组实施传统的大隐静脉高位结扎剥脱术;观察组采用点式剥脱术结合射频消融。分析比较围手术期两组患者的相关指标、炎症因子浓度水平、血液流变学方面的指标、静脉临床严重程度。结果:观察组手术操作的具体时长、术后住院具体的天数均比对照组明显缩短,且观察组术中具体的出血量比对照组显著减少(P<0.05)。观察组术后7 d瘤坏死因子-ɑ(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive Protein,CRP)水平均比对照组明显降低(P<0.05)。观察组术后7 d纤维蛋白原、高切全血粘度、低切全血粘度水平均比对照组显著降低(P<0.05)。观察组静脉临床严重程度评分(Venous Clinical Severity Score,VCSS)明显比对照组降低(P<0.05)。结论:点式剥脱术结合射频消融治疗大隐静脉曲张能改善围手术期相关指标,降低炎症因子及血液流变学指标水平,促进恢复。

Objective:To discuss the clinical efficacy of punctate stripping combined with endovenous laser ablation in the treatment of great saphenous varicose veins.Methods:Eighty-six patients with great saphenous varicose veins in our hospital from September 2021 to September 2022 were enrolled,and randomly assigned into two groups,with 43 cases each.Control group received high ligation and stripping,while observation group received punctate stripping combined with endovenous laser ablation.Then the evaluation criteria including perioperative indicators,inflammatory cytokine concentrations,hemorheologic parameters and Venous Clinical Severity Score(VCSS)were compared between two groups.Results:Compared with control group,observation group had decreased operation time,shorter length of stay,and less intraoperative blood loss,with statistical difference(P<0.05).Serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)at postoperative 7 day were notably lower in observation group than in control group(P<0.05).The values of fibrinogen,whole blood viscosity at high and low shear rate at postoperative 7 day were remarkably decreased in observation group compared with control group(P<0.05).Observation group scored lower on VCSS than control group after operation(P<0.05).Conclusion:Application of punctate stripping combined with endovenous laser ablation in the treatment of great saphenous varicose veins can effectively improve the perioperative indicators,attenuate the inflammation response,reduce the hemorheologic parameters and promote the recovery.