腔内射频闭合治疗下肢静脉曲张

Radiofrequency endovenous obliteration for the treatment of varicose veins

目的评价下肢大隐静脉曲张射频闭合治疗的临床疗效。方法20例（23条下肢）大隐静脉曲张接受射频消融闭合治疗，选用合适的射频导管（6F或8F）在超声引导下插入大隐静脉至隐股静脉交界下方0.5 cm处，保持85℃的情况闭合大隐静脉。结果射频闭合治疗患者20例，23条肢体，射频闭合时间30-40 min，患者平均术后住院日5 d，无一例术后皮下淤血、皮肤灼伤或小腿麻木（隐神经损伤），术后症状缓解，3例踝部轻度肿胀，适当抬高患肢、理疗处理2个月后消退；2例足靴区溃疡，术后5周愈合；术后随访12-30月，术后1个月、4个月、8个月、12个月定期超声检查，所有患者大隐静脉主干均闭合良好，无复发临床表现，深静脉通畅，无血栓形成。结论大隐静脉射频闭合术具有创伤小、并发症少、恢复快等优点，是治疗下肢大隐静脉曲张值得选择的方法之一。

Objective To evaluate therapeutic efficacy of radiofrequency endovenous obliteration （RFO） for the treatment of varicose veins of the lower extremities. Methods Twenty eases （23 extremities） with varicose veins were underwent RFO. The suitable catheter（6F or 8F） was inserted into greater saphenous vein（GSV）. The tip of the catheter was placed to the point 5mm below the femoral-saphenous junction and confirmed by ultrasound. The greater saphenous vein was closuered at 85℃. Results Twenty-three limbs performed RFO with 100% success in technique and the mean time of procedure was 30-40 minutes. The average hospital stay was 5 days. There were no events of subcutaneous hematoma, skin burn and leg numbness happened. The symptoms were all improved postoperatively. The moderate swelling in ankle in 3 cases were observed and disappeared after extremities-raised and physiotherapy in 2 months. The ulceration in ankle in 2 cases were healed 5 weeks after operation. Twelve to 30 months clinical and ultrasound follow-up showed all GSV were completely occluded. There were no thrombosis found in deep vein and no varicosis recurred. Conclusions RFO has the advantage of mini-invasion,less complications and faster recovery. It is an alternation for the treatment of varicose veins of the lower extremities.