两种术式治疗下肢静脉溃疡150例临床疗效比较

Clinical Effect Comparison of Two Operative Methods for Venous Ulcers in Leg

目的:探讨激光闭塞联合透光直视旋切术治疗下肢静脉溃疡的临床效果。方法:回顾性分析2008年1月至2010年12月期间,我科68例施行大隐静脉高位结扎剥脱术及82例施行激光闭塞联合透光直视旋切术的静脉溃疡形成患者的手术耗时、术后恢复情况及患者满意度。结果:68例施行大隐静脉高位结扎剥脱术手术平均耗时(93±13)min,施行激光闭塞联合透光直视旋切术耗时明显缩短(52±6)min,两者有统计学差异。施行大隐静脉高位结扎剥脱术65例术后溃疡愈合良好,愈合时间为(42±8)d,余3例行清创植皮后,创面愈合;施行激光闭塞联合透光直视旋切术78例术后溃疡愈合良好,愈合时间(28±6)d,余4例复行清创植皮后,创面愈合。两组患者均未出现术后皮肤坏死、溃疡复发。手术效果,施行激光闭塞联合透光直视旋切术者更为满意。结论:激光闭塞联合透光直视旋切术能够有效地缩短静脉溃疡形成患者的手术时间和溃疡愈合时间。

Objective： To explore the effect of endovenous laser therapy combined with transilluminated powered phlebectomy in the treatment of primary great saphenous varicose veins with venous leg ulcer. Method： Retrospective analysis operation time, postoperative recovery and satisfaction of primary great sain our hospital. Result： Operation time in patients who received high peeling ligation operation was（93 ± 13 ） minutes, statistically longer than those who received endovenous laser therapy combined with transilluminated powered phlebectomy （ t = 9.26, P〈0.05 ）. Ulcers in 65 patients who received high peeling ligation operation healed well, average cost （42±8 } days. Remained 3 cases recoverd after later debridement graft as wound was large. Ulcers in 78 patients who received endovenous laser therpy combined with transilluminated pow- ered phlebectomy healed well, average cost （28±6）days. While the rest 4 cases recoverd after later debride- ment graft as wound was large. Patients all did not appear postoperative skin necrosis, ulcer recurrence. Pa- tients who received endovenous laser therapy combined with transilluminated powered phlebectomy were more satisfied with operation effect. Conclusion： Endovenous laser therapy combined with transilluminated powered phlebectomy could effectively shorten operation time and ulcer healing time.