腔内激光联合手术治疗下肢静脉曲张243例:中长期临床效果分析

Endovenous laser treatment of varicose veins in lower extremities:Long-term clinical analysis of 243 cases

目的:探讨腔内激光(Endovenous laser treatment,EVLT)联合手术治疗下肢静脉曲张的中长期临床疗效,评价其安全性及有效性。方法:243例病人278条患肢,按照国际静脉联盟CEAP分级,C2:86条肢体,C3:41条肢体,C4:126条肢体,C5:7条肢体,C6:18条肢体。分别采用单纯激光治疗、大隐静脉激光治疗联合高位结扎和股静脉瓣膜成形术等不同方式治疗,术后对患者进行随访,分析术后中长期临床效果及并发症。结果:治疗均获成功,手术时间平均264分钟±5分钟,术后平均3天至5天出院。随访211例,随访率86.5%,随访6个月至52个月,中远期并发症包括1、皮肤感觉异常、针刺或麻木感:8.6%(24/278);2、皮下硬结合并血栓性静脉炎:12.6%(35/278):3、局部曲张静脉残留或复发:6.8%(19/278);4、大隐静脉再通:6.1%(17/278)。结论:腔内激光治疗静脉曲张疗效显著,创伤小,并发症少,优与传统手术治疗。但在临床应用中还需与传统手术治疗相结合,并规范化操作流程。

Objective:To investigate the long-term therapeutic effect of endovenouse laser treatment(EVLT)of varicose veins in the lower limbs.Methods:According to CEAP classification,there were C2 in 86 limbs,C3 in 41 limbs,C4 in 126 limbs,C5 in 7 limbs.278 limbs,in 243 patients were treated by EVLT or EVLT combined with external banding valvuloplasty of superficial femoral vein or EVLT combined with ligation of great saphenous vein and denudation of superficial varicosities.Results:211 cases were followed up for 6～52...