围手术期乌司他丁的应用对改良曲张大隐静脉腔内激光治疗术的作用

Therapeutic effect of ulinastatin intravenous infusion combined with improved endovenous laser ablation on great saphenous vein varicosity

目的观察乌司他丁干预曲张大隐静脉改良腔内激光治疗术术后的疗效,并进行健康相关生命质量分析,进一步探讨曲张静脉改良术式术后并发症的治疗。方法大隐静脉曲张患者50例,经术前查体及多普勒超声检查排除严重深静脉反流等,应用乌司他丁加改良激光治疗术式操作;调取2009年5月至2010年8月应用传统激光治疗术式操作的50例患者作为对照组;观察2组术后3、12个月患者术后复发情况并据SF-36进行健康相关生命质量分析。结果患者术后3、12个月健康程度、健康情况、生理状态、躯体角色、心理情况、情感角色、疼痛程度、精神状态、社会角色、健康状态差异及术后复发差异无统计学意义(P>0.05),术后3个月治疗组疼痛影响2(1)、对照组2.5(1),差异有统计学意义(P<0.05);患者对腔内激光治疗术两种术式均表示满意,治疗组2(1),对照组2(1),差异有统计学意义(P=0.12);术后2组复发率(12个月)对照组4.84%,治疗组1.49%差异有统计学意义(P=0.3505)。结论患者在对两种治疗方式的选择上表现较为一致,术后3、12个月复发率未表现出差异,而乌司他丁加改良腔内激光治疗术在术后疼痛的影响上要低于传统手术,具有优势。

Objectives To observe the therapeutic effect of ulinastatin intravenous infusion combined with improved endovenous laser ablation （IEVLA） on great saphenous vein varicosity （ GSVV）, and to analyze health-related life quality. Methods Fifty patients with GSVV who were examined by Doppler ultrasonography to exclude severe deep vein countercurrent were treated by ulinastatin intravenous infusion combined with improved endovenous laser ablation （trial group） ,and the other 50 patients who were admitted in our department between May 2009 and August 2010 were treated by traditional laser therapy （control group）. The relapse condition at 3,12 months after the operation was observed for both groups, and the health-related life quality analysis was performed according to SF-36. Results There were no significant differences in the health levels, health condition, physiological state, body functions, psychological condition, feeling role, pain degree, mental status, social role, sanitation and relapse after operation at 3 months, 12 months after operation, as compared with those before operation （ P 〉 0.05 ）. However there was a significant difference in the pain degree between control group and trial group （ P 〈 O. 05 ）. There was no significant difference in the satisfactory degree of patients to IEVLA operation between two groups （ P 〉 0.05 ） , and there was no significant difference in the relapse rate after operation between two groups （ P 〉 0.05 ）. Conclusion The patients with great saphenous vein varicosity have basically same selection for the two therapy ways, and there is no significant difference in relapse rate at 3 months, 12 months after operation between two kinds of treatment methods, however, the effect of ulinastatin intravenous infusion combined with improved endovenous laser ablation on postoperative pain is less than that in traditional operation.