TriVex系统下肢曲张静脉刨吸术的并发症分析

TriVex system for the treatment of lower extremity varicose veins

目的探讨和分析TriVex系统治疗下肢静脉曲张的并发症及其防治。方法回顾性分析2002年10月至2008年6月采用TriVex系统刨吸术治疗单纯性下肢静脉曲张患者108例（146条腿）的临床资料。术前均经彩色多普勒超声证实深静脉通畅。结果108例（146条腿）治疗均获成功．平均手术时间为（34±8）min，随访98例，随访率90．4％，随访时间1～24个月，平均15个月。并发症包括：（1）皮下血肿：26条肢体出现血肿，经处理治愈。2条腿出现张力性血泡经刺破后治愈：血肿并发症发生率为17．8％。（2）皮肤感觉异常、针刺或麻木感：13．0％（19／146）。（3）皮下硬结：11．6％（17／146）。（4）局部曲张静脉残留或复发：3．4％（5／146）。（5）切口相关并发症包括感染、对合不良等：4．8％（7／149）。结论TriVex系统刨吸术是治疗下肢静脉曲张血管的安全有效的方法，避免了传统手术方法切口过多、过长的缺点：

Objective To evaluate tile TriVex system in the treatment of varicose veins of lower extremities, focusing on postoperative complications and management. Methods Clinical data of 108 patients （ 146 legs） of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analvzed. Deep veinous pateney was verified in all patients by preoperative sonography. Above knee stripping of the great saphenous vein was done first when necessary. The below knee phlebectomy of the side branches was done with the new system （Trivex System/Smith and Nephew）. Postoperative patients were followed-up, and results were evaluated. Results Procedure was successful in all cases. 98 cases were followed up for 1 - 24 months. The mean operation time per leg was （ 34 ± 8 ） minutes. Complications were as following： 26 legs （ 17.8% ） developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma, which was successfully managed by puncture aspiration. Transien skin numbness or paraesthesia developed in 13.0% （19/146）. Subcutaneous induration in 11.6% （17/146） cases. Residual varicose and recurrence in 3.4% （5/146）. Incision related complications developed in 4.8% （7/149） cases. Conclusion Transilluminated powered phlebeetomy （TriVex） is a safe and effective cosmetic procedure for less invasive varicose vein surgery.