大隐静脉曲张应用EVLA与NMIS两种术式治疗的疗效观察及并发症相关因素分析

Therapeutic Observation and Analysis of Complication Related Factors in the treatment of Varicosis of great Saphenous Vein with EVLA and NMIS

目的:分析应用EVLA与NMIS两种术式治疗大隐静脉曲张的疗效及并发症相关因素。方法:将2016年8月至2017年11月期间因大隐静脉曲张于我院进行治疗的218例患者作为研究对象。参考随机序列发生法将所有研究对象分为EVLA组与NMIS组,其中EVLA组对象均采用腔内激光消融治疗;NMIS组对象采用新型微创剥脱器治疗。对比两组在经不同手术治疗后疗效、各项临床指标及并发症情况的差异。结果:两组在手术时间上无显著差异(P>0.05),NMIS组术中出血量及住院时间显著高于EVLA组(P<0.05),平均住院费用显著低于EVLA组(P<0.05);两组VCSS与CIVIQ评分均显著高于治疗前(P<0.05),两组经治疗VCSS与CIVIQ评分对比无显著差异(P>0.05);NMIS组与EVLA组均存在麻木、血肿、瘀斑等并发症,感染为NMIS组单独存在,且NMIS组并发症发生率显著高于EVLA组(P<0.05)。结论:EVLA与NMIS两种术式在针对大隐静脉曲张临床治疗时均具有各自的优势,但仍存在一定的局限性,临床应用时可根据患者自身情况对手术方式进行选择,最终目的为提高手术治疗效果,减少术中及术后不良事件的发生。

Objective： To analyze the curative effect and related factors of the treatment of varicose saphenous vein with EVLA and NMIS. Methods： A total of 218 patients with varicosities treated in our hospital from August 2016 to November 2017 were enrolled in this study. All patients were divided into EVLA group and NMIS group according to the random sequence generation method. All the patients in EVLA group were treated with endovascular laser ablation. The NMIS group was treated with new minimally invasive dissection device. The curative effect,clinical indicators and complication of the two groups were compared after different surgical treatment. Results： There was no significant difference in operative time between the two groups（P 0.05）. The mean amount of bleeding and hospital stay in NMIS group was significantly higher than that in EVLA group（P 0.05）,mean hospitalization expense was significantly lower than that in EVLA group（P 0.05）; VCSS and CIVIQ scores of two groups were significantly higher than before treatment（P 0.05）,there was no significant difference between the two groups in the treatment of VCSS and CIVIQ score（P 0.05）;The complications of numbness,hematoma and ecchymosis were found in both NMIS group and EVLA group.The infection was independently present in the NMIS group,and the incidence of complications in the NMIS group was significantly higher than that in the EVLA group（P 0.05）. Conclusion： Both EVLA and NMIS have their own advantages in clinical treatment of varicose saphenous vein,but there are still some limitations.The clinical application of EVLA and NMIS can be based on the patient＇s own situation to choose the surgical approach,the ultimate goal is to improve surgical treatment effect,reduce the occurrence of intraoperative and postoperative adverse events.