大隐静脉曲张三种手术方法临床疗效比较

Comparison of three different surgical modalities in treatment of varicose veins

选取2007年2月至2012年1月就诊的单纯性大隐静脉曲张患者215例,根据手术方法不同分为A组（采用传统高位结扎加分段剥脱术,75例）、B组（采用静脉腔内激光术,69例）、C组（采用微创透光旋切术,71例）;比较各组患者手术一般情况及术后并发症发生情况.结果显示,B、C两组单侧手术时间、手术出血量、住院时间均显著低于A组（均P＜0.05）;A、B两组住院费用显著低于C组（均P＜0.05）;A、B两组皮下硬结发生率显著高于C组,且差异有统计学意义（P＜0.05）;A组皮下淤血发生率显著高于B、C两组（P＜0.05）.随访2年后,A、B两组复发率均显著高于C组（x2分别为8.592、5.672,P值分别为0.003、0.016）.提示,三种手术方法治疗大隐静脉曲张具有各自的特点,医师在治疗时应根据患者的病情、意愿及手术方法的特点,选择适宜的手术方法.

Total 215 patients with simple varicosis of great saphenous vein underweni surgical treatment in our hospital from February 2007 to January 2012,including 75 cases receiving traditional high ligation segmentation stripping operation （group A）,69 cases receiving endovenous laser light therapy （group B）,and 71 receiving minimally invasive translucent atherectomy （group C）.The efficacy and postoperative complications were compared among 3 groups.The operation time,intraoperational bleeding and length of hospitalization in groups B and C were significantly less than those in group A （P ＜ 0.05）.The hospitalization cost of groups A and B was significantly lower than that of group C （P ＜ 0.05）.The incidence of subcutaneous induration in groups A and B was significantly higher than that of group C （P ＜ 0.05）.The incidence of subcutaneous congestion in group A was significantly higher than that in groups B and C （P ＜0.05）.The recurrence rate during 2-years of follow-up in groups A and B was higher than that in group C （x2 =8.592,5.672,P =0.003,0.016）.Three surgical modalities in treatment of great saphenons varicose veins have advantage and disadvantages,the appropriate methods should be chosen based on the characteristics of procedures and the condition and intention of patients.