改良大隐静脉腔内闭合联合点状剥脱术治疗下肢浅静脉曲张的疗效观察

Treatment effect of improved saphenous vein intraluminal closure combined with point-like exfoliation for varicose veins in lower extremities

目的对比改良大隐静脉腔内闭合联合点状剥脱术与大隐静脉高位结扎加硬化剂注射术治疗下肢静脉曲张的临床疗效。方法回顾性分析2009年5月至2011年5月本院行改良大隐静脉腔内闭合联合点状剥脱术患者568例(676条患肢)和接受大隐静脉高位结扎加硬化剂注射术的患者487例(585条患肢),两组随访比较并发症及术后复发情况。结果两组患者静脉曲张均得到治愈。对照组出现皮下硬结57例,皮下瘀斑70例,血管血栓性浅静脉炎75例;改良组出现皮下硬结40例,皮下瘀斑55例,血管血栓性浅静脉炎60例。总体复发率两组间无统计学差异,但改良组大隐静脉主干复发率明显低于对照组。结论改良大隐静脉腔内闭合联合点状剥脱术对大隐静脉主干和大的分支行彻底剥脱临床效果佳,手术相对微创,大隐静脉主干复发率低,值得推广。

Objective To investigate the clinical efficacy of improvedsaphenous vein intraluminal closure combined with point-like exfoliation and great saphenous vein ligation with sclerotherapy for the treatment of varicose veins of the lower extremities. Methods A total of 568 patients（676 limbs）underwent modified great saphenous vein combined with point-like exfoliation and 487 patients（585 limbs）underwent high ligation of saphenous vein with sclerotherapy in pur hospital from May 2009 to May 2011 were retrospectively analyzed. The complications and recurrence were compared between the two groups.Result 57 patients in the control group developed subcutaneous induration of the thigh along the saphenous vein, subcutaneous ecchymosis was observed in 70 patients, and foam sclerotherapy was given in75 patients with vascular thrombosis superficial phlebitis. Improved group; 40 cases of patients with improved thigh along the saphenous vein walking subcutaneous induration occurred, 55 patients had subcutaneous ecchymosis; 60 patients with foam sclerotherapy injection of vascular thrombosis superficial phlebitis. There was no statistically difference between the two groups in the overall recurrence rate, while the recurrence rate of main trunk of the great saphenous vein of the improved treatment group was significantly less than the control group. Conclusion The clinical effect of improved saphenous vein intraluminal closure combined with point-like exfoliation of the saphenous vein trunk and large branches of complete stripping is satisfactory with minimally invasive requirements. Trunk recurrence rate is low and is worth for promoting.