X线导向下聚桂醇泡沫硬化治疗下肢静脉曲张

Foam sclerotherapy of lauromacrogol under X-ray guidance for lower extremity varicose veins

目的探讨X线导向下使用聚桂醇泡沫硬化剂治疗下肢静脉曲张的临床应用价值。方法在X线监控下,21例患者共计27条下肢曲张静脉采用聚桂醇泡沫硬化剂注射治疗,全部患者采用留置针经皮穿刺曲张静脉注入泡沫硬化剂,2例患者采用逆行插管至患肢大隐静脉主干内注入泡沫硬化剂,术后先辅以弹力绷带包扎,后改穿弹力袜。结果所有患肢均成功注射泡沫硬化剂于曲张血管内,每条肢体平均使用3.7个经皮穿刺点、平均注入18.3 ml泡沫硬化剂(聚桂醇/空气为1∶4)。平均住院时间3.9 d。随访1～9个月,硬化治疗的曲张静脉消失96.3%(26/27),活动后酸胀、沉重感消失。造影复查显示硬化治疗的曲张浅静脉完全闭塞88.9%(24/27),血管变细11.1%(3/27),未出现严重并发症。结论 X线导向下聚桂醇泡沫硬化治疗下肢静脉曲张具有创伤小、恢复快、操作简单、费用低的特点,是一种安全有效的治疗下肢静脉曲张的方法。

Objective To evaluate the applied value of X-ray guided foam sclerotherapy using lauromacmgol for lower extremity varicose veins. Methods Twenty-seven legs in 21 patients with lower extremity varicose veins were treated with injecting lauromacrogol, a foam sclerosing agent, into varicose veins under X-ray guidance. All patients underwent the procedure of percutaneous puncture with a retaining needle for injecting foam sclerosing agent into varicose veins, and 2 patients performed retrogade catheterization inserting to the trunk of great saphenous vein of sick limb under X-ray guidance for foam sclerotherapy. The elastic bandage was first used after procedure and then replaced with compression stockings for one month. Results Lauromacragol was successfully injected in varicose veins in all patients. There were average 3.7 puncture sites and 18. 3 ml lauromacrogol in one leg. The average hospitalization time was 3.9 days. During the follow-up period （range, 1-9 months）, the varicose veins of sclerotherapy were disappeared, and the fatigue sensation of patients also disappeared. The venous angiogram showed complete occlusion rate of veins undergone sclerotherapy was 88.9% （24/27）, and the percentage of thinned veins was 11.1% （3/27）. No serious complications were found. Conclnsions X-ray guided foam sclerotherapy using lauromacrogol for lower extremity varicose veins is a feasible, microinvasive,lower expense, safe and effective method.