泡沫硬化疗法与传统外科手术治疗下肢静脉曲张的临床研究

Retrospective clinical study of the foam sclerotherapy and traditional surgery in the treatment for varicose veins of lower extremity

目的比较泡沫硬化疗法联合大隐静脉主干髙位结扎和(或)腔内激光闭塞术与传统外科手术治疗下肢静脉曲张的临床效果。方法收集2008年1月至2015年12月在上海市浦东医院普外科住院手术治疗的下肢静脉曲张患者共990例,根据手术方式分为传统手术组517例和硬化治疗组473例。传统手术组行大隐静脉高位结扎剥脱术联合点状抽剥术,硬化治疗组行泡沫硬化疗法联合大隐静脉主干高位结扎术和(或)腔内激光闭塞。观察患者手术时间、住院费用、术后住院时间、术后疼痛、手术切口数量、手术前后主观感受改善程度以及术后并发症。结果硬化治疗组在手术时间、住院费用、术后住院时间、术后疼痛、手术切口数量、手术前后主观感受改善程度以及术后并发症等方面明显优于传统手术组(P<0.05)。结论与传统手术治疗相比,泡沫硬化疗法联合大隐静脉主干髙位结扎和(或)腔内激光闭塞治疗具有安全、可靠、简单、经济、可重复的特点,将成为一项具有明显特色的微创治疗技术。

Objective To compare the clinical effect between foam sclerotherapy joint saphenous vein backbone high ligation or endovenous laser occlusion and the traditional surgery in the treatment for varicose veins of lower extremity. Methods This study was a retrospective study. The patients with varicose veins of lower extremity underwent surgery in Putong Hospital from January 2008 to December 2014 were divided into traditional group （517 patients） and sclerotherapy （473 patients）. The traditional group performed saphenous vein ligation exfoliation and point stripping surgery. The sclerotherapy group performed foam sclerotherapy combined with saphenous vein high ligation and/or endovenous laser occlusion. The operative time, postoperative hospital stay, cost of hospitalization, surgical incision, postoperative pain, improvement before and after surgery subjective feelings and postoperative complications were analyzed. Results The outcomes of the sclerotherapy group were significantly better than that of the traditional group in operative time, postoperative hospital stay, cost of hospitalization, surgical incision, postoperative pain, subjective feelings before and af- ter surgery, postoperative complications（P〈0.05）. Conclusion Compared with the traditional surgery, foam sclerotherapy joint saphenous vein backbone high ligation or endovenous laser occlusion is an effective and safe treatment method.