传统手术与激光腔内治疗下肢静脉曲张的临床观察

Clinical Observation of Traditional Operation and Endovenouser Laser Treatment for Lower Extremity Varicose Veins

目的探讨激光腔内治疗下肢静脉曲张的效果和安全性.方法将146例下肢静脉曲张病人分为微创治疗组(激光腔内治疗)74例,传统治疗组(用传统手术)72例.微创治疗组采用小切口大隐静脉高位结扎、血管腔内原位闭合,属支及交通支电凝、结扎;传统治疗组大隐静脉高位结扎、抽剥,属支及交通支切除、结扎.观察术后效果、并发症的情况.结果所有病人下肢肿胀、酸痛、乏力在手术后1个月逐步消失;皮肤色素沉着在术后1个月减轻,3月逐步恢复.传统手术没有皮肤烧灼发生,但其并发症多.小腿皮肤麻木、皮下瘀斑、创口血肿以及踝以下肿胀比较,两组差异有统计学意义,传统治疗组并发症明显多于微创治疗组.全部病例无下肢深静脉血栓形成和切口感染.结论激光腔内治疗下肢静脉曲张,简单可行,微创、疗效确切.

Objective To evaluate the efficiency and safety of mini-invasion with endovenouser laser on lower extremity varicose veins. Methods 146 cases with lower extremity varicose veins were divided into two groups： mini-invasive treatment group （group A, 74 cases） with endovenouser laser and traditional treatment group （group B, 72 cases）. In group A, mini-incision in great saphenous vein high ligation, lumen of blood vessel closure in situ, and blood vessel branches and communicating branches electric coagulation and ligation were used. In group B, great saphenous vein high ligation, blood vessel branches and communicating branches resection and ligation were used. After the operation, efficiency and complications of these methods were carefully observed. Results In all cases, the symptoms of swelling in lower extremity, soreness, and infirmity disappeared within one month after operation. Skin pigmentation was alleviated within one month after the operation, and disappeared gradually within three months. In group B, there were more complications but no skin cauterization. To compare the complications of skin numbness of legs, infra-skin ecchymosis, wound hematoma, and swellings below ankle, the complications in in group B were more significant than those in group A. In all cases, there was no deep vein thrombosis of lower extremity and wound infection. Conclusion Endovenouser laser is a simply operated, mini-invasive, and effective in varicose veins of lower extremity treatment.