下肢静脉曲张的泡沫硬化与腔内射频治疗的疗效观察与对比分析

Foam sclerotherapy versus endovenous radiofrequency ablation for the treatment of varicose veins of lower extremity: a comparative study

目的探讨泡沫硬化与腔内射频消融治疗下肢静脉曲张的疗效,并进行对比分析。方法2007年至2011年收治44例下肢静脉曲张患者,分为对照组24例(30条下肢),行腔内射频消融治疗,试验组20例(25条下肢),行泡沫硬化治疗。回顾性分析两种方法治疗下肢静脉曲张的疗效并进行对比。结果两种方法的技术成功率均为100%。对照组和试验组在住院期间分别有14条(46.7%)和13条(52%)患肢下肢曲张静脉消失,16条(53.3%)和12条(48%)患肢下肢曲张静脉明显减少。术后6个月时,血管超声和(或)血管造影复查显示对照组和试验组分别有25条(83.3%)和19条(76%)患肢大隐静脉主干闭塞,5条(16.7%)和6条(24%)患肢大隐静脉管腔变窄;28条(93.3%)和24条(96%)下肢酸胀感消失,2例和1例患者下肢酸胀感无明显改善,30条(100%)和25条(100%)患侧下肢皮肤瘙痒感均有改善或消失。试验组患者均无明显硬化治疗术后的严重并发症。两种方法治疗大隐静脉主干曲张病变的疗效差异无统计学意义(P>0.05)。结论泡沫硬化与腔内射频消融比较,具有适应证广、操作简便、疗效好、经济、恢复快的优点,在下肢静脉曲张的微创治疗方面具有一定的优势及广泛的临床应用价值。

Objective To evaluate the foam sclerotherapy and endovenous radiofrequency ablation in treating varicose veins of lower extremity and to compare the curative effect of the two therapies. Methods During the period from 2007 to 2011, a total of 44 patients with varicose veins of lower extremity were admitted to authors＇ hospital. The patients were divided into control group （n = 24, with 30 diseased limbs in total） and study group （n = 20, with 25 diseased limbs in total）. Endovenous radiofrequency ablation was carried out in the patients of control group, while foam sclerotherapy was employed in the patients of study group. The clinical results were retrospectively analyzed by using chi-square test and compared between the two groups. Results The technical success rate was 100% for both groups. Doting hospitalization disappearance of varicose veins was seen in 14 limbs （46.7%） and 13 limbs （52%） of the control group and the study group respectively, and obvious improvement in the severity of varicosity was found in 16 limbs （53.3%） and 12 limbs （48%） of the control group and the study group respectively. Six months after the operation re-examination with vascular ultrasound and/or angiography revealed that main great saphenous vein was occluded in 25 limbs （83.3%） of the control group and in 19 limbs （76%） of the study group, and narrowed great saphenous vein was detected in 5 limbs （16.7%） of the control group and in 6 limbs （24%） of the study group. The feeling of aching pain at the lower extremity disappeared in 28 limbs （93.3%） of the control group and in 24 limbs（96%）of the study group. No improvement in aching pain of the lower extremity was seen in 2 cases of the control group and in one case of the study group. Disappearance of improvement of cutaneous pruritus was seen in all diseased limbs of the both groups. No remarkable foam sclerotherapy-related severe complications occurred in the patients of the study group. No statistically significant difference in the effectiveness for the varicosity of the main great saphenous vein existed between the two therapies （P 〉 0.05）. Conclusion Compared with endovenous radiofrequency ablation, foam sclerotherapy is technically-simple, mini-invasive, effective and economical with wider indications in treating varicose veins of lower extremity. It is of value to use this technique in clinical practice.