腔内激光灼闭术与抽剥术治疗下肢静脉曲张疗效比较

Effects of endovenous laser treatment and strip extraction surgery for lower ectremities varicose veins

目的探讨腔内激光灼闭术治疗下肢静脉曲张的临床疗效。方法将240例患者按治疗方法不同分为腔内激光灼闭手术组(激光组,120例)和高位结扎+抽剥手术组(抽剥组,120例),激光组采用810 nm激光连续发射模式,灼闭大隐静脉主干及其属支,小腿局部较严重曲张静脉者,联合点式法剥除,抽剥组通过抽剥器剥除大隐静脉主干,局部及散在静脉,通过点式法剥除。结果所有患者手术过程顺利,围手术期死亡1例,1例出现同侧深静脉血栓。两组比较,临床疗效差异无统计学意义,激光组并发症发生率、手术时间、住院时间均优于抽剥组,差异有统计学意义(P<0.05)。结论与单纯高位结扎+抽剥术相比较,腔内激光灼闭术治疗下肢静脉曲张,微创、美观、简单、安全、有效、较大的缩短了手术时间、住院时间,是一种值得推广的临床治疗方法。

Objective To study the effect of Intracavity laser ignition treatment for varicose veins of lower extremities. Methods All 240 cases were randomly divided into the endovenous laser treatment group （laser group, 120 cases） and high ligation＋strip extraction surgery group （strip group, 120 cases）, the laser group with 810 nm laser continuous emission model, burning closed great saphenous vein trunk and branches; For the calf local severe varicose vein, joint point method stripping; the strip group through the stripping device sipping great saphenous vein trunk, for local and scattered vein, through the point method sipping. Results All patients operation process smoothly, and 1 death during perioperative period, 1 case with ipsilateral deep vein thrombosis. Two groups of comparisons, clinical curative effect no significant differences, complications, the timing of the operation, hospitalization time the laser group were superior to the strip group, the difference was statistically significant （P 〈 0.05）, Conclusion Contrast the pure high ligation＋ strip extraction surgery, The treatment of endoluminal laser is a mirco-traumatic, slinky, simple, safe and effective method and shortened the length of stay materially, which should be used widly.