大隐静脉曲张腔内激光治疗术后并发症原因分析及预防

Causes and Prevention of Complications in Endovenous Laser Treatment for Patients with Varicose Great Saphenous Veins

目的探讨腔内激光治疗(endovenous laser treatment,EVLT)大隐静脉曲张术后并发症发生原因及防治。方法回顾我院2003年8月～2007年2月采用大隐静脉高位结扎联合EVLT治疗342例(530条肢体)大隐静脉曲张,分析术后186条肢体出现的并发症。结果随访6个月,23条肢体皮下淤血、血肿,65条肢体静脉炎反应,20条肢体皮肤烧伤,经治疗全部治愈。77条肢体隐神经损伤(皮肤感觉异常),经治疗57条治愈,余20条好转。1例深静脉血栓形成并发肺栓塞,经治疗好转。结论EVLT术中联合大隐静脉高位结扎,根据部位适当调整激光功率,轻柔操作,术后早期活动及预防性抗凝等措施,可预防或减少并发症的发生。

Objective To discuss the causes and therapies for the complications induced by endovenous laser treatment （EVLT） in patients with varicose great saphenous vein. Methods From August 2003 to February 2007,totally 342 patients （530 limbs） with varicose great saphenous veins were treated by high ligation combined with EVLT in our hospital. Operative compilations were found in 186 of the limbs.The data of the 186 limbs were analyzed retrospectively. Results The patients were followed up for 6 months,during which 23 limbs showed skin bruises and/or hematoma,65 develped phlebitis,and 20 had skin burns, all of these cases were cured. In addition,77 limbs were diagnosed as having saphenous nerve damage （abnormal skin sensation）,57 of them were cured and 20 were improved after treatments. Deep vein thrombosis complicated with pulmonary embolism was found in one case,who was improved after therapies. Conclusions To prevent the complications of EVLT combined with high ligation of the saphenous vein,intraoperative adjustment of laser power according to the surgical sites,gentle operation,postoperative administration of anticoagulants,and early rehabilitation are recommended.