射频消融联合泡沫硬化剂注射术治疗下肢静脉曲张的临床疗效观察

Concomitant endovenous radiofrequency ablation and foam sclerotherapy for the treatment of varicose veins

目的评价静脉射频消融(RFA)联合泡沫硬化剂注射治疗下肢静脉曲张的临床疗效。方法 120例(120条肢体)下肢静脉曲张患者随机分为观察组和对照组,每组60例。观察组组利用射频能量闭合大隐静脉主干,小腿曲张静脉行泡沫硬化剂注射。对照组使用传统方法高位结扎剥脱大隐静脉,曲张浅静脉行点式剥脱处理。比较2组患者的术后住院时间、术后并发症和一年后彩色多普勒随访情况。结果观察组住院时间短,术后24h疼痛较轻,术后患者皮肤瘀斑、切口感染、隐神经损伤较少,与对照组比较差异具有统计学意义(P<0.05)术后1年2组患者的静脉曲张复发和大隐静脉闭塞率方面没有统计学差异(P>0.05)。结论 RFA联合泡沫硬化剂注射临床上安全、有效,具有创伤小、恢复快等优点,是一种可部分替代传统手术的有效方法。

Objective To evaluate the clinical efficacy of endovenous radiofrequency ablation combined with foam sclerotherapy in the treatment of varicose veins of lower extremity. Methods A total of 120 patients（120 limbs） with varicose veins were randomly divided into observation group and control group, 60 cases in each group. Observation group using radio frequency energy to close the main saphenous vein, calf varicose vein sclerosing agent injection. The control group using traditional methods of high ligation stripping saphenous vein, varicose veins line point stripping treatment. The postoperative hospital stay, postoperative complications and color Doppler follow-up were compared between the two groups. Results The observation group had a shorter hospital stay, less pain at 24 hours after operation, postoperative skin ecchymosis, incision infection and less damage to the saphenous nerve compared with the control group（P〈0.05）. There was no significant difference in patients with recurrent varicose veins and saphenous vein occlusion rate（P〉0.05）. Conclusion RFA combined with foam sclerotherapy is safe and highly efficacious in the management of varicose veins. Patients treated with combination therapy given in this manner demonstrated less trauma and faster recovery.