大隐静脉腔内激光术与高位结扎结合点式抽剥术对下肢静脉曲张患者VCSS评分及应激指标的影响

Effect of Great Saphenous Vein Intracavitary Laser Operation and High Ligation Combined with Point Stripping Operation on VCSS Score and Stress Index of Patients with Varicose Veins of Lower Extremities

目的:比较大隐静脉腔内激光术与高位结扎结合点式抽剥术对下肢静脉曲张患者静脉临床严重程度评分(VCSS)及应激指标的影响。方法:回顾性选取2018年6月-2021年6月南京医科大学附属江苏盛泽医院普外科及苏州大学附属第二医院血管外科收治的100例下肢静脉曲张患者。根据手术方式将其分为常规组(n=50)和观察组(n=50)。常规组给予高位结扎结合点式抽剥术,观察组给予大隐静脉腔内激光术。比较两组围手术期指标,术前、术后6个月VCSS评分,术前及术后应激指标。结果:观察组住院时间、手术时间均短于常规组(P<0.05)。术后6个月,观察组VCSS评分低于常规组(P<0.05)。术后,两组丙二醛(MDA)水平较术前均升高,超氧化物歧化酶(SOD)水平较术前均降低(P<0.05),观察组MDA水平低于常规组,SOD水平高于常规组(P<0.05)。结论:与高位结扎结合点式抽剥术相比,大隐静脉腔内激光术用于下肢静脉曲张患者中能够缩短住院时间、手术时间,降低静脉临床严重程度,减轻应激反应,值得推广。

Objective:To compare the effect of great saphenous vein intracavitary laser operation and high ligation combined with point stripping operation on venous clinical severity score(VCSS)score and stress index of patients with varicose veins of lower extremities.Method:A total of 100 patients with varicose veins of lower extremities admitted to General Surgery Department of Jiangsu Shengze Hospital Affiliated to Nanjing Medical University and Vascular Surgery Department of the Second Affiliated Hospital of Suzhou University from June 2018 to June 2021 were retrospectively selected.They were divided into routine group(n=50)and observation group(n=50)according to the operation mode.The routine group was given the high ligation combined with point stripping operation,and the observation group was given the great saphenous vein intracavitary laser operation.The perioperative indexes,VCSS scores before and 6 months after operation,and preoperative and postoperative stress indexes were compared between the two groups.Result:The hospital stay and operation time in the observation group were shorter than those in the routine group(P<0.05).Six months after operation,the VCSS score of the observation group was lower than that of the routine group(P<0.05).After operation,the level of malondialdehyde(MDA)in both groups was higher than that before operation,and the level of superoxide dismutase(SOD)was lower than that before operation(P<0.05),the level of MDA in the observation group was lower than that in the routine group,and the level of SOD was higher than that in the routine group(P<0.05).Conclusion:Compared with high ligation combined with point stripping operation,the application of great saphenous vein intracavitary laser operation in patients with varicose veins of lower extremities can shorten the hospital stay,operation time,reduce clinical severity of veins,and reduce stress reaction,which is worth popularizing.