半导体激光腔内闭合术联合高位结扎治疗下肢静脉曲张疗效

An assessment of the endovenous semiconductor laser combined with high ligation in treatment of varicose venous in lower extremity

目的:观察应用激光腔内闭合术联合高位结扎治疗下肢静脉曲张的临床效果。方法:2007年3月至2012年2月间我院收治的278例下肢静脉曲张患者(共342条肢体)分别行激光腔内闭合术联合高位结扎(A组,286条肢体)及大隐静脉高位结扎+剥脱术(B组,56条肢体)。比较两组的手术时间、术后48 h疼痛视觉模拟评分、术后首次下床时间、术后住院天数;术后第6个月比较手术前后CEAP分级、患者自身对手术效果及整体满意度评价。结果:两组患者手术时间、住院天数差异无统计学意义(P>0.05),但A组术后48 h疼痛较轻、下床时间稍早(P<0.05);术前和术后6个月两组的CEAP分级、手术效果评分比较差异有统计学意义(P<0.05),组间差异则无统计学意义(P>0.05);但术后患者的整体评价A组优于B组(P<0.05)。结论:激光腔内闭合术联合高位结扎治疗下肢静脉曲张微创美观、患者满意度高,是此疾病目前较理想的治疗手段之一。

Objective： To observe results of varicose vein in lower extremity treated by great saphenous vein high ligation combined with endovenous semiconductor laser treatment. Methods： Two hundred and seventy-eight patients（ 342 limbs） with varicose vein in lower extremity treated from March 2007 to February 2012 were divided into two groups. Group A（ 286 limbs） were treated by great saphenous vein high ligation combined with endovenous semiconductor laser treatment,and group B（ 56 limbs） were treated by great saphenous vein high ligation and stripping. Operative time,48-hour postoperative pain visual analogue scale（ VAPS） values,getting out of bed for the first time after surgery and postoperative average hospital stay were compared between the two groups. CEAP classifications were compared before operation and 6 months after operation. Scores were evaluated for the effect of surgery and self satisfactions by patients themselves between the two groups. Results： There were not significantly different about operative time and average hospital stay between the two groups（ P〉0. 05）. However,the pain at 48 h postoperative,the time of getting out of bed were less and earlier in group A than those in group B（ P〈0. 05）. The change of CEAP classification and the cores of the effect of the operation were significantly different before and after surgery in the two groups（ P〈0. 05）,there were no significant differences between the two groups（ P〈0. 05）; However,postoperative evaluation was better in group A than that in group B（ P〈0. 05）. Conclusion： Endovenous semiconductor laser treatment combined with high ligation for treatment of varicose venous in lower extremity has less trauma,faster recovery and beautiful appearance,furthermore,it has high self satisfaction rate,which is one of the ideal treatment for this disease.