静脉曲张腔内激光治疗的超声观察

Ultrasound observation of endovenous laser therapy for varicose veins

目的 以多普勒超声系列观察大隐静脉曲张腔内激光治疗（Endovenous Laser Treatment，EVLT）术后的形态变化过程，揭示EVLT治疗下肢静脉曲张的机制。方法选择12例（14条肢体）单纯性大隐静脉曲张患者以810nm激光行腔内治疗，参数为重复脉冲模式12w、脉冲1s、间隔1S，光纤回抽速度2～3mm／s。术后1周、1个月、3个月、6个月、1年及每年一次以多普勒超声测量平卧位时髌骨内侧髁上5cm处大隐静脉内径。结果 所有病例成功施行了EVLT，临床疗效满意。超声观察术后早期大隐静脉管壁显著增厚，管腔缩小，内充满不规则的实质性低回声，后期血管腔内低回声逐渐消失，管壁收缩，大约在术后1～2年期间形成疤痕或完全消失。结论 EVLlT术后多普勒超声观察揭示EVLT可以完全消除曲张静脉，达到根治的效果。

Aim To observe and describe gross morphological changes of great saphenous varicose veins underwent endovenous laser treatment （EVLT） with serial duplex scanning,to explore the mechanism of EVLT for lower extremity varicose vein. Methods Twelve patients with 14 great saphenous varicose veins underwent EVLT at this study. Parameter：repetitive pulse 12 w,square pulse Is,interval 1 s, pumpback speed 2 ～ 3mm/s. All patients were evaluated clinically and were re-examined by duplex US at 1 week and 1,3,6,12 and 24 months after operation. Results All patients were treated successfully with EVLT. The gross morphological changes of varicose veins after endovenous laser therapy are dynamic development. GSV inner diameters decrease progressively after operation, and at 1 year and beyond,complete disappearance of the GSV or minimal residual fibrous cord with no flow detectable. Conclusions This study finds that EVLT can achieve radical cure for lower extremity varicose vein, with complete elimination of varicose veins.