腔内射频消融闭合术治疗老年人下肢浅静脉曲张的随访研究

Follow-up analysis of endovenous radiofrequency obliteration for a treatment of superficial varicosities in lower extremity in the elderly

目的 评价腔内射频消融闭合术治疗老年人下肢浅静脉曲张的临床疗效.方法 选择接受过腔内射频消融闭合术治疗的35例（43条患肢）原发性大隐静脉曲张老年患者进行随访、分析,大隐静脉主干均全程射频治疗,其中23条患肢同时行高位结扎大隐静脉,20条患肢未行高位结扎,根据临床症状、体征改善情况及彩色多普勒超声检查结果评价术后1～3年的疗效.结果 腔内射频消融闭合术联合行大隐静脉高位结扎组大隐静脉主干闭塞率明显高于未行高位结扎组,分别为21例（91.3%）和14例（70.0%）,二者比较差异有统计学意义（χ^2=5.467,P〈0.05）;且再通率明显降低,分别为2例（8.7%）和8例（30.0%）,差异有统计学意义（χ^2=4.251,P〈0.05）;局部浅静脉曲张复发率降低.差异有统计学意义[0例与4例（20.0%）,χ^2=7.030,P〈0.01].结论 腔内射频消融闭合术治疗老年下肢浅静脉曲张微创、安全、美观、疗效可靠,联合行大隐静脉高位结扎术,疗效可能更好,但需要进一步长期随访观察.

Objective To evaluate the therapeutic effect of radiofrequency endovenous obliteration （RFO） on superficial varicosities in lower extremity in the elderly. Methods The clinical data of 35 elderly patients （43 limbs） with primary great saphenous varicose vein, who were treated with RFO （20 limbs） or RFO in combination with high ligation procedures （23 limbs）, were analyzed retrospectively. The therapeutic effects were evaluated at 1-3 years after RFO by the improvement of clinical symptom and signs, as well as results of color Doppler ultrasonography. Results Compared with single RFO group, the obstruction rate of great saphenous vein was higher [21（91.3%） vs. 14（70.0%）, χ^2 =5.467, P 〈 0. 05], and the recanalization rate was lower [2（8.7%） vs. 8（30.0%）,χ^2=4.251, P〈0.05] in RFO combined with high ligation group. The recurrence rate of local varicose veins was lower[0 vs. 4（20. 0%）,χ^2 =7. 030, P〈0. 013 in RFO plos high ligation group than in single RFO group. Conclusions RFO is an effective treatment with less trauma, more safety and less scars. Combined with high ligation procedure, the effectiveness may be better.