高位结扎联合氰基丙烯酸酯封闭治疗对大隐静脉曲张患者血清D-二聚体、C反应蛋白表达及VCSS评分的影响

Effects of high ligation combined with cyanoacrylate sealing on expressions of D-dimer,C-reactive protein and VCSS score in patients with varicose great saphenous vein

目的:探究高位结扎联合氰基丙烯酸酯封闭对大隐静脉曲张患者术后血清D-二聚体、C反应蛋白表达水平及静脉临床严重程度评分表(VCSS)评分的影响。方法:回顾性分析61例(73条患肢)大隐静脉曲张患者的临床资料,依据手术方案不同分为对照组29例与研究组32例,对照组行高位结扎治疗,研究组行高位结扎联合氰基丙烯酸酯封闭治疗。比较两组血清D-二聚体与C反应蛋白表达水平、VCSS评分、血液流变学指标、深静脉血栓形成发生率。结果:(1)术后7 d对照组血清D-二聚体高于术前(P<0.05),术后7 d两组血清C反应蛋白表达水平均低于术前(P<0.05),且术后7 d研究组血清D-二聚体、C反应蛋白表达水平均低于对照组(P<0.05)。(2)术后1个月两组VCSS评分均低于术前(P<0.05),且术后1个月研究组VCSS评分低于对照组(P<0.05)。(3)术后7 d两组纤维蛋白原、血浆黏度、红细胞压积均高于术前(P<0.05),且术后7 d研究组纤维蛋白原、血浆黏度、红细胞压积均低于对照组(P<0.05)。(4)两组深静脉血栓形成发生率比较,差异无统计学意义(P>0.05)。结论:高位结扎联合氰基丙烯酸酯封闭能调节大隐静脉曲张患者术后血清D-二聚体、C反应蛋白表达水平,有效控制病情,改善血液流变学指标,预防深静脉血栓形成。

Objective:To investigate the effects of high ligation combined with cyanoacrylate sealing on the expressions of D-dimer,C-reactive protein,and the VCSS score in patients with varicose great saphenous vein.Methods:The clinical data of 61 patients(73 limbs) with varicose great saphenous vein were analyzed retrospectively.According to the different operative plan,the patients were divided into control group(29 cases) and study group(32 cases).The control group was treated with high ligation,and the study group was treated with high ligation combined with cyanoacrylate sealing.The expression levels of D-dimer and C-reactive protein,VCSS score,hemorheology indexes and the incidence of deep vein thrombosis were compared between the two groups.Results:The level of serum D-dimer in the control group 7 days after operation was higher than that before operation(P<0.05),and the expression levels of serum C-reactive protein in the two groups 7 days after operation were lower than those before operation(P<0.05),and the expression levels of D-dimer and C-reactive protein in the study group was lower than that in the control group(P<0.05).One month after operation,the VCSS scores of the two groups were lower than those before operation(P<0.05),and the VCSS score of the study group was lower than that of the control group(P<0.05).The fibrinogen,plasma viscosity and hematocrit in the two groups 7 days after operation were higher than those before operation(P<0.05),and the fibrinogen,plasma viscosity and hematocrit in the study group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of deep vein thrombosis between the two groups(P>0.05).Conclusion:High ligation combined with cyanoacrylate sealing can regulate the expression levels of D-dimer and C-reactive protein in the serum of patients with varicose great saphenous vein,effectively control the disease,improve the hemorheology indexes,and prevent deep vein thrombosis.