优化手术流程对大隐静脉曲张手术效果的影响

Effect of optimizing surgical procedures on surgical outcomes of varicose great saphenous vein

目的 探讨优化手术流程对大隐静脉曲张手术效果的影响。方法 收集2021年8月至2022年12月于首都医科大学附属北京积水潭医院进行大隐静脉高位结扎剥脱术联合大隐静脉硬化剂治疗的97例大隐静脉曲张患者的临床资料,根据是否采取优化手术流程将患者分为优化组(n=55)和常规组(n=42)。比较两组患者的专科病情[病程、病变部位、临床表现-病因学-解剖学-病理生理学(CEAP)分级]、手术相关指标(手术时间、手术摆台时间和术中出血量)以及术后住院期间并发症的发生情况。结果 两组患者的病程、病变部位、CEAP分级比较,差异均无统计学意义(P﹥0.05)。优化组患者的手术时间、手术摆台时间均明显短于常规组患者,术中出血量明显少于常规组患者,差异均有统计学意义(P﹤0.01)。术后住院期间,优化组患者并发症总发生率低于常规组患者,差异有统计学意义(P﹤0.05);优化组患者手术部位皮下出血面积占单侧下肢面积的百分比明显小于常规组患者,差异有统计学意义(P﹤0.01)。两组患者术后3个月内均无需进行二次手术。结论 优化手术流程可以缩短手术时间,提高手术质量,降低手术相关并发症的发生风险,值得临床推广。

Objective To analyze the effect of optimizing surgical procedures on the surgical outcomes of varicose great saphenous vein.Method Clinical data of 97 patients with varicose great saphenous vein who received high ligation and exfoliation combined with sclerotherapy of the varicose great saphenous vein from August 2021 to December 2022 at Beijing Jishuitan Hospital,Capital Medical University were collected.According to optimization of surgical procedures,all patients were divided into the optimization group(n=55)and conventional group(n=42).The specialty conditions[course of disease,lesion site,clinical etiology anatomy pathophysiology(CEAP)grading],surgical-related indexes(operation time,operation setting time and intraoperative blood loss)and postoperative complications during hospitalization were compared between the two groups.Result There was no significant difference in the course of disease,lesion site and CEAP grading between the two groups(P>0.05).The operation time and operation setting time of patients in the optimization group were significantly shorter than those in the conventional group,and the intraoperative blood loss of patients in the optimization group were significantly lower than that in the conventional group, the differences were statistically significant (P<0.01). The total incidence rate of complications during postoperative hospitalization in the optimization group was lower than that in the conventional group, the differences was statistically significant (P<0.05). The percentage of subcutaneous bleeding area to the unilateral lower limb area of the optimization group was significantly lower than that of the conventional group, the differences was statistically significant (P<0.01). There was no need for patients of the two groups to undergo a second operation within 3 months after surgery. Conclusion Optimizing surgical procedures can shorten surgical time, improve surgical quality, and reduce the risk of surgical related complications, which is worthy of clinical promotion.