经皮透光动力旋吸术治疗下肢静脉性皮肤溃疡

Percutem transilluminated powered phlebectomy in treatment of dermal ulcers of varicose veins of lower extremity

目的探讨经皮透光动力旋吸术治疗下肢静脉性皮肤溃疡的疗效和安全性。方法将149例下肢静脉性皮肤溃疡患者分为两组:动力旋吸术组(A组,76例),用激光行大隐静脉全程原位闭合,用经皮透光动力旋吸小腿曲张静脉和溃疡基底部;传统手术组(B组,73例),大隐静脉高位结扎、抽剥,小腿曲张静脉及交通支切除、结扎。观察两组治疗效果和并发症发生情况。结果传统手术组患者小腿皮肤麻木、大腿瘀斑、创口血肿等并发症多于旋吸术组,两组比较有显著差异(P<0.05)。旋吸术组患者术后2周、1个月下肢溃疡例数少于传统组,两组比较有显著差异(P<0.05)。旋吸术组患者术后2周下肢肿胀、乏力症状的例数少于传统组(P<0.05)。两组均无下肢深静脉血栓形成和切口感染。结论经皮透光动力旋吸术治疗下肢静脉性皮肤溃疡,简单可行,疗效确切。

Objective To evaluate efficacy and safety of percutem transilluminated powered phlebectomy in treatment of venous skin ulcers of lower limb.Methods One hundred forty-nine cases with lower limb varicose veins were divided into two groups:Group A (76 cases,transilluminated powered phlebectomy group): endovenous laser for closure in situ of full great saphenous vein and percutem transilluminated powered phlebectomy for leg varicose veins and ulcer base were performed.Group B (73 cases,control group): high ligation and stripping of great saphenous vein as well as resection and ligation of leg varicose veins and perforating veins were performed.Outcomes and complications of both groups were reviewed.Results In group B,the incidence of leg numbness,thigh ecchymosis and wound hematoma were significantly more in group B than group A (P<0.05).Cases whose leg ulcers still existed at 2-week,4-week postoperatively were less in group A than group B (P<0.05).Cases who had leg swelling and fatigue were significantly less in group A than group B (P<0.05).In addition,in both groups,there were no deep vein thrombosis of lower extremity and incision infection.Conclusion It is simple and effective for percutem transilluminated powered phlebectomy to treat venous skin ulcers.