直接光纤置入腔内激光治疗大隐静脉曲张

Treatment of great saphenous varicosity by inserting optical fiber straigat into EVLT

目的探讨改进静脉腔内激光(EVLT)治疗下肢大隐静脉曲张的方法。方法采用激光治疗系统,利用动静脉留置针直接光纤置入EVLT治疗单纯性大隐静脉曲张205例(257条肢体)。结果手术时间35～55min,平均45min,术后住院5～7d,术后随访3～12个月,平均为6个月。术后2个月:浅静脉曲张治愈率97.3%(250/257),下肢酸胀乏力治愈率93.7%(150/160),皮肤色素沉着治愈率91.8%(56/61),肿胀治愈率90.9%(20/22)。并发症:皮肤灼伤10例(3.9%),小腿麻木、剌痛9例(3.5%),皮下结节15例(5.8%)。术后无深静脉血栓形成。切口甲级愈合。结论利用动静脉留置针直接光纤置入EVLT治疗大隐静脉曲张疗效确切,操作简单。

Objective To investigate the methods of treating great saphenous varicosity by inserting optical fiber straight into EVLT, Methods Wuhan Linyun Laser Therapeutic System was introduced to treat 205 cases （257 limbs） of great saphenous varicosity. Optical fiber instead of blood vessel sheath and catheter was inserted straight into endovenous laser treatment（EVLT） through arteriovenous permanent needle was adopted. Results Operations lasted 35-55 minutes,averaging 45 minutes. Patients were hospitalized for 5- 7 days. Postoperative visits were followed for 3-12 months,averaging 6 months. Two months after the operation,appraisal according to the curative effect evaluation criteria was carried on. The cure rate for superficial varicosity is 97.3% （250/257）, for lower extremities swelling asthenia is 93.7% （150/160） ,for skin pigmentation is 91.8 % （56/61） ,and for swelling is 90.9 % （20/22）. 10 cases（3.9 % ） suffered from skin ambustion. 9 cases（3.5 % ） suffered from shank anesthesia and stabbing pain. 15 cases（5.8 % ） suffered from hypodermic tubercle. The patients had not deep venous thrombosis after the operation and the wounds healed well. Conclusion Inserting optical fiber straight into EVLT through arteriovenous permanent needle brings about more accurate treatment. It can be operated simply, causing small wounds and less pain.