综合性外科治疗在下肢静脉曲张患者中的临床疗效观察

Evaluating the Therapeutic Effects of Comprehensive Surgical Treatment for Varicose Veins in Lower Extremities

【目的】探究综合性外科治疗下肢静脉曲张的临床疗效。【方法】选取2012年5月至2014年1月本院收治的下肢静脉曲张患者276例（326务患肢）为研究对象，按照随机数字表法将患者分为观察组和对照组，每组138例（163条患肢）。对照组采用传统的手术方式，观察组采用综合外科治疗手段。记录手术进行时间，术后并发症、相关症状消失情况及不良反应情况。【结果】观察组平均手术时间显著低于对照组，差异具有统计学意义（P〈0．05）。经过治疗后观察组患者小腿内侧皮肤麻木感觉减退、皮下瘀血及皮下条索样硬结等并发症情况均优于对照组，差异具有统计学意义（P〈0．05）。术后对患者随访平均58个月，观察组下肢酸胀乏力完全消失、肢体皮肤色素沉着完全消失、肢体皮肤湿疹完全消失及肢体浅静脉曲张完全消失优于对照组，差异具有统计学意义（P〈0．05）。【结论】联合应用射频消融、腔内激光治疗和选择性大隐静脉内翻剥脱术综合治疗下肢静脉曲张具有微创、操作简单，手术时间明显减少，创伤小的优点，值得临床推广。

[Objective]To investigate the therapeutic efficacy of comprehensive surgical treatment for varicose veins of lower extremities. [Methods] A total of 276 cases of patients with varieose vein of lower extremi- ty （326 limbs） in our hospital from May 2012 to January 2014 was selected. The patients were randomly and equally divided into observative group （138 cases） and control group （138 cases） using a random number table. The control groups were treated with traditional surgery, while the observative groups were received comprehesive treatments. Surgery time, postsurgery complications, symptom improvement and other changes were recorded.[Results]the mean operation time is significantly shorter in observative group when compared to control group （ P 〈0.05）. Postsurgery complications including skin numbness or feeling loss at medial lower leg, subcutaneous congestion, and subcutaneous sclerosis are statistically less in ohservative group than controi group （ P〈0.05）. After average 58 months postsurgery follow up, symptoms improvement or disappearance including lower extremity weakness/fatigue, skin pigmentation, eczematous changes, or varicose, is signifi- cant better in observative group than control group （ P〈0.05）.[Conclusion] Combination of radiofrequency ablation, endovenous laser treatment, and selectively surgical removal of great saphenous vein varus stripping is a minimally invasive, easily perform, and shortening operation time for lower extremity varicose veins. It should be widely used clinically.