激光腔内闭合联合高位结扎与大隐静脉高位结扎剥脱术治疗下肢静脉曲张的疗效比较

Comparative study of the efficacy of varicose vein in lower extremity treated by great saphenous vein high ligation combined with endovenous laser treatment and great saphenous vein high ligation and stripping

目的比较应用激光腔内闭合术(EVLT)联合高位结扎与大隐静脉高位结扎+剥脱术治疗下肢静脉曲张的临床效果。方法将2007年3月至2012年2月间我院收治的278例下肢静脉曲张患者(共342条肢体)分成EVLT联合高位结扎组(A组,286条肢体)和大隐静脉高位结扎+剥脱术组(B组,56条肢体)。比较两组的手术时间,术后48h疼痛视觉模拟评分(VAPS),术后首次下床时间,术后住院天数;术后第6个月比较手术前后CEAP分级、患者自身对手术效果及整体满意度评价。结果两组手术时间、住院天数比较差异无统计学意义(P>0.05),但A组术后48 h疼痛较轻、下床时间稍早(P<0.05);术前和术后6个月两组的CEAP分级、手术效果评分比较,差异有统计学意义(P<0.05),组间差异则无统计学意义(P>0.05),但术后患者的整体评价A组优于B组(P<0.05)。结论 EVLT联合高位结扎术治疗具有与传统手术相似的效果,患者满意度高,值得临床推广。

Objective To compare the efficacy of varicose vein in lower extremity treated by great saphenous vein high ligation combined with endovenous laser treatment (EVLT) and great saphenous vein high ligation and stripping. Methods Two hundred and seventy-eight patients (342 limbs) with varicose vein in lower extremity treated in our hospital from March 2007 to February 2012 were divided into two groups. Group A(286 limbs) were treated by great saphenous vein EVLT combined with high ligation, while group B(56 limbs) were treated by great saphenous vein high ligation and stripping. Operative time, 48-hour postoperative pain visual analogue scale (VAPS) values, getting out of bed for the first time after surgery and postoperative average hospital stay were compared between the two groups. CEAP classifications were compared before operation and 6 months after operation. Scores were evaluated for the effect of surgery and self satisfactions by patients themselves between the two groups. Results There were no significant differences in operative time and average hospital stay between two groups (P>0.05). However, the pain at 48 h after surgery and the time of getting out of bed were less and earlier in group A than those in group B (P<0.05). The change of CEAP classification and the scores of the effect of the operation were significantly different before and after surgery in the two groups (P<0.05). There were no significant differences between the two groups (P>0.05). However, postoperative evaluation was better in group A than that in group B (P<0.05). Conclusion EVLT combined with high ligation for treatment of varicose vein in lower extremity has a similar efficacy with great&nbsp;saphenous vein high ligation and stripping. Moreover, it has high self satisfaction rate, which is worth for clinical application.