腔内射频与传统手术治疗下肢静脉曲张对照研究

Comparison of intracavitary radiofrequency and traditional surgery in the treatment of lower limb varicosity

目的 探讨腔内射频术与传统手术治疗下肢静脉曲张患者的临床疗效和安全性.方法 将112例下肢静脉曲张患者按手术方法不同分为两组,研究组64例（106条病肢）采用腔内射频术治疗,对照组48例（78条病肢）采用传统大隐静脉曲张高位结扎及剥离术治疗,术后观察随访6个月.比较两组临床疗效、手术期间各项观察指标变化、术后并发症发生率及复发率.结果 两组总有效率均为100%,但研究组显效率（92.3%）显著高于对照组（76.4%）（χ2=8.77,P〈0.01）.研究组手术时间显著短于对照组、手术切口显著小于对照组、术中出血量显著少于对照组,下床时间显著早于对照组,术后严重疼痛率显著低于对照组（P〈0.01）;术后各种并发症发生率均显著低于对照组（P〈0.05或0.01）.6个月随访两组复发率比较差异无统计学意义（P〉0.05）.结论 腔内射频术治疗下肢静脉曲张操作便捷、手术创伤小、恢复快、疗效确切、并发症少等,显著优于传统大隐静脉曲张高位结扎及剥离术治疗,值得在临床推广应用.

Objective To compare the clinical therapeutic effects and safety of intracavitary radiofrequency and traditional surgery in the treatment of patient with lower limb varicosity. Methods 112 patients with lower limb varicosity were recruited and separated to study group （64 patients with 106 affected limbs） and control group （48 patients with 78 affected limbs）, intracavitary radiofrequency ablation was used in study group, and high ligation of great saphenous vein （GSV） and stripping were used in control group, the follow-up observation was 6 months. Comparison of clinical efficacy, changes of indexes during surgery, postoperative complication rate and recurrence rate in two groups were conducted. Results The total effective rate in both groups was 100%, and the rate in study group （92.3%） was significantly higher than that （76.4%） in control group （X2 =8.77, P〈0. 01）. The operation time, incision, amount of bleeding, time for ambulation, and postoperative severe pain in study group were all significantly better than those in control group （P〈0.01）; the postoperative complication rate in study group was significantly lower than that in control group （P〈0.05 or 0.01）. After 6 months of follow-up, there was no significant difference in recurrence rate between two groups （P〉0.05）. Conclusion To treat lower limb varicosity with intracavitary radiofrequency has the advantages of convenient operation, small operation wound,quick recovery, obvious curative effect and less complication, and it is significantly superior to the traditional high ligation of GSV and stripping surgery, is worthy of extensive clinical applications.