泡沫硬化疗法治疗下肢静脉曲张伴溃疡的疗效分析

Foam sclerotherapy curative effect analysis for the treatment of varicose veins of lower limbs with ulcers

目的探讨泡沫硬化疗法在下肢静脉曲张伴溃疡治疗中的效果及预后。方法选取2013年1月至2016年1月接受治疗的下肢静脉曲张患者275例,其中210例患者伴发溃疡,根据治疗方法将其分为传统组(136例,310条,102例伴发溃疡)、硬化组(139例,303条,108例伴发溃疡)。硬化组在数字减影血管造影(DSA)引导下大隐静脉高位结扎+泡沫硬化剂治疗,传统组行大隐静脉高位结扎+腹腔镜深筋膜下交通支离断术(SEPS)和(或)点状抽剥。对比两组手术时间、住院费用及时间、术后并发症等。根据患者主观感受评价术后效果。结果硬化组平均手术时间、术后平均住院时间均较传统组用时短,住院费用也低于传统组,对手术更为满意。传统组术后31.62%的患者出现局部疼痛,硬化组术后25.18%的患者出现局部疼痛,传统组并发症发生率明显高于硬化组。结论泡沫硬化疗法对伴或不伴溃疡的下肢静脉曲张患者均具有较好的疗效,相对传统治疗方法,泡沫硬化疗法在减少并发症方面更具优势,在DSA引导下大隐静脉高位结扎+泡沫硬化剂治疗下肢静脉曲张伴溃疡有效可行。

Objectiye Analyze foam sclerotherapy in treating lower limb varicose veins with ulcer effect and prognosis. Methods From January 2013 and January 2016,275 patients treated with varicose veins of lower limbs,including 210 cases of patients with ulcer,were selected. According to the patient treatment were divided into traditional group（136 cases,136,102 patients with ulcer）,the sclerosis group（139 cases, 139,108 patients with ulcer）,Patients in sclerosis group performed great saphenous vein high ligation under DSA guidance combined with foam sclerotherapy,those in traditional group performed lines of great saphenous vein high ligation combined with laparoscopic surgical traffic its broken under the deep fascia（SEPS）and（or）dot stripping. Operation time,hospitalization expenses and time,postoperative complications between the two groups were compared according to the subjective evaluation of patients with postoperative effect. Results Average operation time,postopera-tive hospital stay of sclerosis group were less than those of traditional group,hospitalization expenses were lower,the operation was more satisfacto-ry. Local pain occurred in 31. 62% of patients after the traditional group,25. 18% of patients after sclerosis of the group,and the complications of traditional group was obviously higher than that of sclerosis group. Conclusion Foam sclerotherapy for patients with or without ulcer of lower limb varicose veins has good curative effect. Compared with the traditional treatment methods,foam sclerotherapy has more advantage in reducing complications. Great saphenous vein high ligation under DSA guidance combined with foam sclerotherapy of varicose veins can be chosed to treat lower limb ulcer.