两种不同术式治疗下肢静脉功能不全的近期疗效对照研究

Endovenous radiofrequency ablation in combination with TriVex for treatment of chronic venous insufficiency of the lower extremity

目的评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效。方法150例下肢静脉功能不全患者（150条患肢）随机分为A、B两组，每组75例。A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术，B组行大隐静脉高位结扎抽剥术联合曲张浅静脉％Vex刨吸术。比较两组手术悒l兄、术后4周患者对手术的自身评价、手术前后CEAP（clinic，etiologic，anatomic and pathophysiologi calclassification）分级和临床严重程度计分（venous clinical severity score，vcss）的变化。结果A、B两组手术时间分别为（67±11）min和（69±9）min（P〉0．05），A组术后疼痛轻、下地时间早、住院天数少、皮下血肿发生率低，但皮下硬结发生率高于B组；对手术的评价A组为（11．21±2．00）分优于B组（10．52±2．08）分，差异有统计学意义（P〈0．05）；两组手术前后CEAP分级和VCSS计分变化差异均有统计学意义（P〈0．01），A、B两组手术前后VCSS分差为（4．6±2．5）分和（4．3±2．7）分（P〉0．05）。结论利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效，且微创、并发症少。CEAP临床分级和VCSS临床记分可用于其疗效评价。

Objective To evaluate the therapeutic efficacy of endovenous radiofrequency ablation in combination with TriVex for the treatment of chronic venous insufficiency （ CVI ） of the lower extremity. Methods One hundred and fifty CVI cases （150 limbs） were randomly assigned to Group A （75 limbs） and Group B （75 limbs）. Patients in Group A were treated with greater saphenous vein radiofrequency ablation procedures in combination with TriVex. Patients in Group B were treated with greater saphenous vein traditional stripping operation in combination with TriVex. The short-term results in hospital and patient self-assessment for the operation at postoperative 4 week were compared with each other; The changes of CEAP classification and venous clinical severity score （VCSS） were compared. Results Operation time was （67 ± 11 ） rain in Group A versus （69 ± 9 ） min in Group B （ P 〉 0. 05 ）. Postoperative pain, average hospital stay in Group A were significantly less and shorter than in Group B （ P 〈 0. 05 ）. The scores of self- assessment for the operation were （ 11.21 ± 2. 00 ） in Group A versus （ 10. 52 ±2. 08 ） in Group B （ P 〈 0. 05）. The change of CEAP classification and VCSS were statistically significant after operation in both groups （ P 〈 0. 01 ）. The VCSS decreased 4. 6 ± 2.5 in Group A versus 4. 3± 2. 7 in Group B （ P 〉 0. 05 ）. Conclusions Endovenous radiofrequency ablation in combination with TriVex for treatment of CVI are effective, less traumatic, of fast recovery. CEAP classification and VCSS are useful tools for assessing outcomes after the operation.