改良曲张静脉点式剥除术联合大隐静脉注射泡沫硬化剂治疗下肢静脉曲张的临床研究

Clinical study of modified varicose vein spot stripping combined with great saphenous vein injection of foam sclerosing agent in the treatment of varicose veins of the lower extremity

目的探讨改良曲张静脉点式剥除术联合大隐静脉注射泡沫硬化剂治疗下肢静脉曲张的临床疗效。方法收集2022年1—12月宁德师范学院附属宁德市医院收治的92例下肢静脉曲张患者的临床资料,按照治疗方法的不同将其分为对照组(n=46,采用改良曲张静脉点式剥除术)和研究组(n=46,采用改良曲张静脉点式剥除术联合大隐静脉注射泡沫硬化剂)。比较两组患者的手术指标及术前、术后3个月反流持续时间(VCT)、峰值流速(Vmax),记录两组患者的临床疗效、并发症发生情况。结果研究组患者手术时间长于对照组患者,差异有统计学意义(P﹤0.05)。两组患者术中出血量、切口数量、住院时间比较,差异均无统计学意义(P﹥0.05)。术后3个月,两组患者VCT均低于本组术前,Vmax均高于本组术前,且研究组患者VCT低于对照组患者,Vmax高于对照组患者,差异均有统计学意义(P﹤0.05)。研究组患者治疗总有效率为100%(46/46),明显高于对照组患者的89.13%(41/46),差异有统计学意义(P﹤0.01)。研究组患者均未发生并发症,低于对照组患者并发症总发生率的8.69%(4/46),差异有统计学意义(P﹤0.05)。结论改良曲张静脉点式剥除术联合大隐静脉注射泡沫硬化剂治疗下肢静脉曲张疗效显著,可快速达到闭塞静脉管腔的治疗目的,有效改善患者下肢深静脉瓣膜功能,加快患者术后康复,安全性较高。

Objective To investigate the clinical efficacy of modified varicose vein fraction combined with saphenous vein injection foam sclerotic agent in the treatment of varicose veins of the lower extremity.Method Clinical data of 92 patients with varicose veins of the lower extremity admitted to Ningde Hospital,Affiliated to Ningde Normal University from January to December 2022 were collected.According to different treatment methods,they were divided into control group(n=46,using improved varicose vein point stripping)and study group(n=46,using improved varicose vein point stripping combined with great saphenous vein injection with foamsclerotherapy).Surgical indicators,valve closure time(VCT)and peak flow velocity(Vmax)before and 3 months after surgery were compared between the two groups.Clinical efficacy was recorded between the two groups,and complications were compared between the two groups.Result The operation time of the study group was longer than that of the control group,the difference was statistically significant(P<0.05).There were no significant differences in the amount of intraoperative blood loss,the number of incisions and the length of hospital stay between the two groups(P>0.05).Three months after surgery,VCT and Vmax in both groups were lower than those before surgery,VCT in study group was lower than that of control group,Vmax in study group was higher than that in control group,the differences were statistically significant(P<0.05).The total effective rate of the study group was 100%(46/46),significantly higher than that of the control group 89.13%(41/46),the difference was statistically significant(P<0.01).No complications occurred in the study group,which was lower than 8.69%(4/46)of the control group,the difference was statistically significant(P<0.05).Conclusion Modified varicose vein point peeling combined with saphenous vein injection foam sclerosing has a significant effect in the treatment of varicose veins of the lower extremity,which can achieve the treatment purpose of occluded venous lumen faster,effectively improve the function of deep vein valves of the lower extremity,accelerate the postoperative recovery of patients,and have high safety.