腔内激光闭合下肢曲张浅静脉术后复发的危险因素分析

Analysis of the risk factors of recurrent lower extremity varicose veins after endovenous laser treatment

目的评价下肢浅静脉曲张激光闭合术(EVLA)术后复发的相关危险因素。方法回顾性分析2006年4月至2016年4月收治的下肢浅静脉曲张肢体15000条,接受大隐静脉高位结扎联合EVLA后统计复发病例并进行Logistic回归分析复发原因。结果术后随访12个月,1440条肢体复发,复发率9.6%。多因素Logistic回归分析发现左髂静脉受压、大隐静脉最大直径>1 cm、下肢曲张静脉团直径>2 cm、患者术后穿弹力袜的依从性,是下肢浅静脉曲张术后复发的危险因素(P<0.05)。结论EVLA治疗下肢浅静脉曲张是可选的手术方式,针对复发的危险因素采取补救措施,可降低术后复发率。

Objective To evaluate the risk factors of recurrent lower extremity varicose veins after endovenous laser treatment（EVLA）. Methods 15000 limbs with lower extremity varicose veins treated by ligation of high saphenous vein with endovenous laser from April 2006 to April 2016 were analyzed retrospectively. Logistic regression analysis was performed on the recurrence risk factors for proposing remedial measures. Results During 12 months＇ follow-up, 1440 limbs（9.6%） showed recurrence. Multivariate logistic regression analysis demonstrated that left iliac vein compression, maximal diameter of the great saphenous vein 1 cm, the diameter of the varicose veins clumps 2 cm, and the patient compliance to post operative elastic stockings were determined as the risk factors of recurrence（P〈0.05）. Conclusion EVLA for varicose veins of the lower extremities is effective. Correct remedies to operation procedures might reduce recurrence rate.