腔内激光闭合术和传统手术治疗下肢静脉曲张的临床研究

Endovenous laser treatment and conventional surgery in varicose veins of lower limbs：a clinical ;study

目的：探讨腔内激光闭合术（EVLT）和传统手术治疗下肢静脉曲张的疗效。方法回顾性分析2010年1月至2011年12月长治医学院附属和济医院收治的下肢静脉曲张患者170例（221条患肢）的临床资料，根据手术方式分为EVLT组93例（122条患肢）和传统手术组77例（99条患肢）。记录两组患者的手术情况、住院时间、并发症、生活质量评分和疾病复发情况。结果与传统手术组比较，EVLT组患者单侧手术时间、单侧术中出血量、疼痛程度和住院时间均显著降低（均P〈0.05）。两组患者术后并发症比较显示，EVLT组患者术后切口愈合不良、患肢疼痛、皮下血肿的发生率均显著降低（均P〈0.05）。两组患者随访前1个月CIVIQ评分总分及疼痛、社会活动、体能、精神心理4类评分组间比较，差异均无统计学意义（均P〉0.05）。两组患者术后1年、3年、5年疾病复发率及复发患肢的CEAP临床分级组间比较，差异均无统计学意义（均P〉0.05）。结论 EVLT与传统手术治疗下肢静脉曲张中期疗效均较好，而EVLT术后并发症较少、恢复时间短。

Objective To investigate the effect of endovenous laser treatment （EVLT） and conventional surgery in varicose veins of lower limbs. Methods The clinical data of 170 patients（221 limbs） with varicose veins of lower limbs,who were hospitalized in Heji Hospital Affiliated to Changzhi Medical College between January 2010 and December 2011,were retrospectively analyzed. According to the surgical treatment,all patients were divided into the EVLT group（n=93,122 limbs）and the conventional surgery group（n=77,99 limbs）. The surgical condition,hospital stay,complications,quality of life and the disease recurrence of the two groups were recorded. Results Compared with the conventional surgery group,the unilateral operation time,unilateral intraoperative blood loss,pain degree and hospital stay were significantly decreased in the EVLT group （all P〈0.05）. Comparing the postoperative complications between the two groups,the incidence of postoperative poor wound healing,affected limb pain and subcutaneous hematoma in the EVLT group were significantly decreased than those in the conventional surgery group（all P〈0.05）. There were no statistically significant differences in the Chronic Venous Insufficiency Questionnaire（CIVIQ）total score and scores of pain,social activity,physical ability and mental health at 1 month before the follow-up between the two groups（all P〉0.05）. No statistically significant difference in the recurrence rate at 1,3 and 5 years after the operation and CEAP clinical classification of the recurrent affected limbs were found between two groups（all P〉0.05）. Conclusion EVLT and conventional surgery show good mid-term effect in varicose＆amp;nbsp;veins of lower limbs,while less postoperative complications and shorter recovery time are found in EVLT.