泡沫硬化疗法治疗大隐静脉曲张34例报告

Sclerosing foam for treatment of great saphenous vein (a report of 34 cases)

目的探讨新型泡沫硬化疗法对大隐静脉曲张的临床治疗效果。方法在超声引导下以新型泡沫硬化剂自2004年8月对34例病人共计36条大隐静脉曲张肢体进行注射硬化治疗。结果36条肢体均在超声引导下成功注射,平均每条肢体应用6·8mL泡沫硬化剂。有16·7%(6/36)大隐静脉于治疗后1个月复诊时实施了第二次注射治疗。平均随访6个月,全部病人(包括第二次注射治疗者)下肢活动后酸胀、乏力感消失,下肢明显的曲张畸形静脉消失;有22%(8/36)仅有小腿局限的轻度曲张。无严重的并发症,病人满意率100%。术后3个月复查血管超声,78%(28/36)大隐静脉主于闭塞或直径<3mm。结论新型泡沫硬化剂注射疗法是一种简单有效的下肢静脉曲张治疗方法。

Objective A preliminary experience of sclerosing foam made of purified sodium tetradecylsulfate is used to treat great saphenous vein. We evaluated the safety and efficacy of the doses and concentrations of the drug. Methods Over a 6 months period, we performed Duplex-guided sclerotherapy using SFT to treat 34 patients with great saphenous vein. SFT was formed using a three-way stopcock and 2 syringes, mixing air with liquid sodium tetradecylsulfate to create foam. The working concentrations and doses of SFT were 1.5 % and 6 - 8 mL. Results At 3-month follow-up, the majority of treated larger veins were either obliterated or showed a normal state of cephalad blood flow. Four patients experienced transient scotomas and developed segmental phlebitis of a collateral vein. The best foam was obtained bv mixing one part liquid sodium tetradecylsulfate and four to five parts air, but the duration of the foam product was also related to several other factors. Conclusion This preliminary, pilot study demonstrates that the technique of producing sclerosing foam according to Tessari＇ s method （ three-way stopcock device） is very promising,especially for larger veins. No serious complications were reported, and further standardization of the method may improve the results and feasibility of this technique. Further studies are needed to validate this new technique.