下肢静脉曲张患者腔内激光闭合术后复发的危险因素分析

Analysis on risk factors of recurrent lower extremity varicose veins after endovenous laser ablation

目的 探讨下肢静脉曲张行腔内激光闭合术（EVLA）治疗后复发的危险因素及防治措施.方法 回顾性分析洛阳市第三人民医院2013年3月至2016年5月行EVLT治疗的512条下肢静脉曲张肢体的临床资料,对复发病例的复发危险因素进行Logistic回归分析.结果 术后随访12～60个月,62条肢体复发,复发率为12.1％.多因素Logistic回归分析发现合并大隐静脉直径〉1.0 cm、静脉曲张团直径〉2.5 cm、下腔静脉阻塞、髂静脉压迫、下肢深静脉血栓后遗症、原发性下肢深静脉瓣膜功能不全、解剖变异等是下肢静脉曲张术后复发的危险因素（P〈0.05）.结论 EVLA治疗下肢静脉曲张疗效满意,针对复发的危险因素选择合理的治疗方案可明显降低术后复发率.

Objective To discuss the risk factors and prevention measures of recurrent lower extremity varicose veins after endovenous laser ablation （ EVLA） .Methods Retrospective analyzed the clinical data of 512 limbs with lower extremity varicose veins treated by EVLA in the Third People ＇s Hospital of Luoyang from March 2013 to May 2016.Logistic regression analysis was performed on the recurrent risk factors of recurrence cases .Results In the duration of follow-up ranged from 12 months to 60 months, 62 limbs recurred and the recurrence rate was 12.1%.Multivariate Logistic regression analysis proved that the diameter of the great saphenous vein 〉1.0 cm, the diameter of the varicose veins clumps 〉2.5 cm, the inferior vena cava obstruction , iliac vein compression , the post-thrombotic syndrome , primary lower extremity deep vein valve insufficiency , and the anatomical variation were proved as the risk factors of recurrence （ P〈0.05 ） .Conclusions EVLA for lower extremity varicose veins is safe and effective , to choose the reasonable treatment in accordance with the risk factors of recurrence can significantly reduce the recurrence rate .