压迫靶静脉对超声引导静脉腔内激光消融羊后肢隐静脉的影响

Effect of target vein compression on ultrasound guided endovenous laser treatment for the saphenous vein in the hind limbs of goat

目的探讨超声引导静脉腔内激光消融（EVLT）过程中压迫与不压迫靶静脉对消融后静脉内膜坏死及静脉壁穿孔的影响。方法解放军总医院第一附属医院动物实验中心提供的10条山羊后肢隐静脉,随机分为超声引导EVLT压迫靶静脉组与非压迫靶静脉组,每组各5条隐静脉。消融前超声扫查隐静脉全程,测量内径。2组分别于超声引导EVLT过程中压迫及不压迫靶静脉。消融后取消融静脉段制作病理切片,光镜下测量并计算静脉内膜坏死率、静脉壁穿孔率。采用t检验比较超声引导EVLT压迫靶静脉组与非压迫靶静脉组消融前静脉内径、消融后静脉内膜坏死率的差异;采用χ2检验比较超声引导EVLT治疗压迫靶静脉组与非压迫靶静脉组消融后静脉壁穿孔率。结果超声引导EVLT压迫靶静脉组与非压迫靶静脉组消融前静脉内径比较,差异无统计学意义[（4.1±0.4）mm vs（4.2±0.4）mm,t=-0.395,P〉0.05];超声引导EVLT非压迫靶静脉组消融后静脉内膜坏死率高于超声引导EVLT压迫靶静脉组,且差异有统计学意义[（96.8±1.8）%vs（88.6±4.4）%,t=-23.26,P〈0.05];超声引导EVLT非压迫靶静脉组消融后静脉壁穿孔率低于超声引导EVLT压迫靶静脉组,且差异有统计学意义[21.1%（16/75）vs 65.6%（49/75）,χ~2=29.57,P〈0.05]。结论超声引导EVLT过程中,不压迫靶静脉消融后静脉内膜坏死率高于而静脉壁穿孔率低于压迫靶静脉。

Objective To discuss the effect of compression and non compression of the target vein on the venous intimal necrosis and venous wall perforation during ultrasound guided endovenous laser treatment（EVLT） for the saphenous vein. Methods Ten goats′ hind limb saphenous veins, provided by the animal experimental center of the First Affiliated Hospital of Chinese PLA General Hospital, were randomly divided into compression of target vein group and non compression of target vein group during ultrasound guided EVLT, each group of 5 saphenous veins. Before EVLT, scan the whole saphenous vein and measure its inner diameter by ultrasound. After the treatment, the rate of venous intima necrosis and the rate of venous wall perforation were compared by pathological examination. The t test was applied to the comparison of the vein diameter before EVLT and the vein intimal necrosis rate after EVLT, and the χ~2 test was applied to compare the rate of venous wall perforation between two groups after EVLT. Results Before EVLT, the mean diameter of the two group were [（4.1±0.4） mm vs（4.2±0.4） mm] respectively, and the difference was not statistically significant by t test（t=-0.395, P 〉0.05）. After EVLT, the necrosis rate of venous intima in the non compression of target vein group was higher than that of compression group, and the difference was statistically significant [（96.8±1.8）% vs（88.6±4.4）%, t=-23.26, P 〈0.05]. After EVLT, the rate of venous wall perforation in the non compression of target vein group was lower than that of compression group, and the difference was statistically significant [21.1%（16/75） vs 65.6%（49/75）, χ2=29.57, P 〈0.05]. Conclusion There was a significant higher necrosis rate of venous intima and a significant lower venous perforation rate in the group treated without compression of target vein during ultrasound guided EVLT for the saphenous veins.