泡沫硬化剂治疗下肢静脉曲张的临床研究

Study on foam sclerotherapy for varicose veins of lower extremities

目的探讨聚桂醇泡沫硬化剂治疗下肢静脉曲张产生的不良反应及其与复发率间的关系。方法下肢静脉曲张病人62例共98条肢体,其中男27例(41条),女35例(57条),对其进行1%聚桂醇泡沫硬化剂注射联合大隐静脉高位结扎并腔内激光治疗术,统计病人疼痛、硬结、色素沉着、肿胀、足靴区麻木感等可能出现的不良反应及复发率。结果失访2例,注射1次57例,2次3例;全部病人下肢活动后酸胀乏力感减轻,下肢曲张静脉明显消退。疼痛37例,浅静脉血栓性硬结43例,50例经口服地奥司明1~3个月后疼痛硬结症状减轻;31例出现色素沉着,其中20例经局部涂抹维生素E美白精华素1~3个月后减轻;6例出现下肢溃疡,于1~3个月后逐渐愈合。1个月随诊时有疼痛硬结反应组与无疼痛硬结反应组比较,6个月后的复发率比较差异有统计学意义(P<0.05);40例未使用维生素E美白精华素病人中,出现色素沉着持续时间与6个月后复发率呈显著相关性(P<0.05)。结论硬化剂治疗过程中,出现疼痛硬结反应、较长时间色素沉着的病人,其静脉曲张复发率越低。

Objective To explore the relationship between recurrence rate and side effects of the treatment of varicose veins in lower extremity with lauromacrogol foam sclerosing agent.Methods The data of 62 patients（98 limbs）with varicose veins was collected,including 27 males（41 limbs）and 35 females（57 limbs）.They were treated with 1% lauromacrogol foam sclerosing agent combined with great saphenous vein high ligation and endovenous laser treatment.Statistical indicators included side effects such as pain,induration,hyperpigmentation,swelling,numbness and the recurrence rate.Results Two patients were lost,57 patients were injected once,further foam sclerotherapy was carried out again for 3 patients.Obvious abnormal varicose veins as well as the soreness and fatigue of lower extremity disappeared in all patients.Thirty-seven patients had pain and 43 patients developed superficial venous thrombotic sclerosis,among which 50 patients faded away after 1 to 3 months by taking diosmin.Thirty-one cases of pigmentation occurred and 20 disappeared after 1 to 3 months by applying the vitamin E whitening essence.Six patients with lower extremity ulcers recovered after 1 to 3 months.Through statistics analysis of the patients in 1-month follow-up,we found that the differences in recurrence rate after 6 months were statistically significant between group with pain induration reaction and group without（P〈0.05）.Among the patients without using the vitamin E whitening essence,there was a significant correlation between the duration of pigmentation and recurrence rate after 6 months.Conclusion In the process of foam sclerotherapy,the more pain induration reaction they had and the longer the duration of pigmentation sustained,the lower the recurrence rate would be accordingly.