全程大隐静脉抽剥术治疗下肢静脉性溃疡中期疗效

Mid-term outcomes of total stripping of great saphenous vein in treating venous ulceration of lower extremity

目的探讨全程大隐静脉抽剥术(TSGS)治疗下肢静脉性溃疡中期疗效。方法回顾性分析下肢静脉性溃疡愈合期患者66例(69条肢体),A组30例行TSGS,B组36例行腔镜下穿通静脉离断术(SEPS)。分别于术后2周、3个月门诊随访,6、12个月及每年电话随访。比较两组患者住院时间、住院费用及术后4年累积溃疡复发率。结果 66例患者术后平均随访时间为37个月。A和B组溃疡复发时间分别为(23.00±1.80)个月和(28.00±5.96)个月(P>0.05)。两组累积溃疡复发率比较无统计学差异。A组住院时间短于B组(P>0.05),住院费用明显低于B组(P<0.01)。结论下肢静脉性溃疡愈合期患者手术可以优先选择TSGS。

Objective To investigate the mid-term outcomes of total stripping of great saphenous vein（TSGS） in treating venous ulceration of lower extremity（VULE）. Methods A total of 66 VULE patients（69 legs）was treated with TSC-S（group A, 30 cases） and subfascial endoscopic perforator surgery（SEPS）（group B, 36 cases）. The patients were followed-up in the 2^nd week and 3^rd, 6^th and 12^th month after surgery. Four-year cumulative ulcer recurrence rate, hospital stay and hospital expenses were compared between two groups. Results Average follow-up time of 66 VULE patients was 37 months. The times of ulcer recurrence in two groups were similar[（23.00±1. 80） months vs. （28. 00±5.96） months]（P〉0. 05）. There was no significant difference in cumulative ulcer recurrence rate between two groups（P〉0. 05）. Hospital expense was lower in group A than that in group B （P〈0. 01）. Conclusion TSGS may be taken as the first choice for VULE patients during healing phase.