微小切口联合泡沫硬化剂注射与传统手术方法治疗大隐静脉曲张的对比研究

COMPARISON OF MINI-INCISION COMBINED WITH FOAM SCLEROTHERAPY AND TRADITIONAL OPERATION TO TREAT INCOMPETENT GREAT SAPHENOUS VEIN

目的 探讨微小切口联合泡沫硬化剂注射治疗大隐静脉曲张的安全性、可行性及优越性。方法 回顾分析97例(109条肢体)大隐静脉曲张患者的临床资料,其中34条肢体实施了微小切口联合泡沫硬化剂注射治疗(治疗组,n=34),75条肢体采用传统的大隐静脉高位结扎剥脱术治疗(对照组,n=75),比较2组患者的手术时间、出血量、切口数量、切口长度、住院时间、并发症、术后复发率。结果 治疗组的手术时间、住院时间短于对照组[(35.3±6.5)min、(4.0±0.8)d vs(85.4±7.9)min、(7.0±1.2)d];治疗组的出血量、切口数量少于对照组[(20.8±3.2)mL、2.3±0.3 vs(67.9±15)mL、6.8±2.4];治疗组的切口总长度短于对照组[(1.8±0.4)cm vs(13.2±3.7)cm]。治疗组术后2周及术后2个月的慢性静脉功能不全生活质量调查表评分均优于对照组[(78.8±9.4)分、(90.1±8.5)分vs(66.8±10.6)分、(74.0±11.6)分]。结论 微小切口联合泡沫硬化刺注射能一次性治疗大隐静脉曲张,既能完全剥除曲张的大隐静脉主干,又能对曲张的静脉属支进行彻底性的治疗,并能充分体现微创外科的优点;既能治疗疾病,又能达到更小的创伤,并能保持体表美观等特点。

Objective To investigate of the safety, feasibility and superiority of mini-incision combined with foam sclerotherapy for the treatment of incompetent great saphenous vein. Methods Retrospective analysis was performed on 97 cases （109 limbs） clinical data of patients with varicosis of great saphenous vein. The mini-incision combined with foam sclerotherapy was performed for 34 limbs （ treatment group, n = 34 ）. 75 limbs （ control group, n = 75 ） with incompetent great saphenous vein underwent high-ligations of the great saphenous vein and stripping. The operation time, bleeding volume, number of the incision, total incision length, hospitalization time, postoperative complications and recurrence rate of the two groups were respectively statistical analyzed. Results The operation time, hospitalization time of the treatment group was shorter than those of control group （ 35.3 ± 6.5 ） min, （4.0 ± 0. 8 ） d vs （ 85.4 ± 7.9 ） min, （ 7.0 ± 1.2 ） d. The bleeding volume and number of the incision of the treatment group were less than those of control group （ 20.8 ± 3.2 ） mL, 2.3 ± 0.3 vs （67.9 ± 15 ） mL,6.8 ±2.4. The total incision length of treatment group was shorter than that of control group （1.8 ± 0. 4）cm vs （ 13.2 ± 3.7 ） era. The chronic venous insufficiency questionicre, score of life quality of postoperative 2 weeks and 2 months of the treatment group were better than those of control group （78.8 ± 9.4） scores, （90.1 ± 8.5 ） scores vs （66.8 ± 10.6 ） scores, （74.0 ± 11.6 ） scores. Conclusion The mini-incision combined with foam sclerotherapy can one-time treat varicose great saphenous vein. Not only can completely stripped varicose saphenous vein, and radically treat the varicose vein, and can fully embody the advantages of minimally invasive surgery, which can cure the disease, but also can achieve minimal trauma, and keep the surface appearance.