微创个体化治疗下肢静脉曲张160例分析

Clinical Analysis of 160 Cases about Individual Treatment for Lower Limbs Varicose vein by. Minimally Invasive Treatment

目的：探讨下肢静脉曲张的微创个体化治疗方法及疗效。方法：回顾性分析2009年1月～2013年6月期间综合应用多种微创方法治疗160例下肢静脉曲张患者的临床资料，共229条肢体；其中单纯应用EVLT15例，21条肢体；高位结扎加EVLT80例，123条肢体；高位结扎加EVLT、局部曲张静脉团块点状剥除48例，63条肢体；高位结扎加EVLT联合腔镜下交通支离断（sEPS）17例，22条肢体。结果：160例患者切口均1期愈合。术后出现大隐静脉主干及小腿局部曲张静脉烧灼处条索状硬结、疼痛30例；不同程度皮下片状瘀宽19例；出现局部皮肤麻木18例。术后复发2例。合并皮肤溃疡的术后经换药后逐渐愈合。所有患者术后临床症状均得到明显改善。141例随访6—54个月。结论：针对患者下肢静脉曲张的不同程度，采用微创个体化治疗，可以进一步提高治愈率，是安全有效的治疗措施。

Objective： To investigate the individual minimally invasive treatment for lower limbs varicose and the effect.Methods： Retrospective reviewed the 160 patients of lower limbs varicose in a variety of minimally invasive treatment from Jan. 2009 to Jun. 2013, total 229 limbs. 21 limbs in 15 patients were cured by endovenous laser treatment （EVLT） only; 123 limbs in 80 patients were cured by high ligation combined with EVLT; 63 limbs in 48patents were cured by high ligation combined with EVLT and local varicose vein mass point removal; 22 limbs in 17 patients were cured by high ligation combined with EVLT and subf- endoscopic surgery （SEPS）. Results： All incisions were primary healing. 30 cases felt pain and block or a column state at great saphenous vein trunk and crus local varicose veins which were burned; 19 cases were found subcutaneous flake ecchymosis; 18 cases felt local skin numbness; 2 cases were recurrence after operation. Patients complicated with skin ulcer healed after operation by dressing change. All the patients had a clinically significant reduction in symptoms and no lower extremity deep vein thrombosis. 141 patients were followed up for 6 -54 months. Conclusion： Lower limbs varicose vein of different degree treat by individualized therapy to improve cure rate and to be an effective measure.