超声引导泡沫硬化治疗静脉曲张术后复发溃疡的疗效分析

Ultrasound-guided foam sclerotherapy of operated cases of venous leg ulcer recurrence

目的探讨超声引导泡沫硬化(UGFS)治疗下肢静脉曲张术后复发溃疡的临床疗效。方法选取2014年6月-2015年12月河北医科大学第一医院收治的行UGFS治疗下肢静脉曲张术后复发溃疡的患者45例,对患者临床资料进行回顾性分析,观察不同组别患者泡沫硬化剂的用量及溃疡愈合时间的差别。结果 3种术式患者术后复发年限比较无差异(P>0.05)。浅静脉+交通静脉治疗组泡沫硬化剂平均用量高于浅静脉组与交通静脉组(P<0.05),C5组与C6组患肢溃疡愈合时间比较有差异(P<0.05)。3组不同性别和肢体溃疡愈合时间比较无差异(P>0.05)。体重指数、年龄与溃疡愈合时间呈正相关(P<0.05)。患者术后并发症血栓性浅静脉炎最常见,发生率为11.1%。有血栓性浅静脉炎患者泡沫硬化剂平均用量高于无血栓性浅静脉炎患者(P<0.05)。术后12个月病变血管完全或部分再通率为20.0%(9/45)。结论 UGFS治疗下肢静脉曲张术后复发溃疡具有治愈率高、并发症少等特点,是一种简便、精准、有效的诊疗方法。

Objective To explore the clinical characteristics and follow-up of venous leg ulcer recurrence after operation.Methods The complete clinical data of 45 patients with postoperative venous ulcer recurrence who underwent ultrasound-guided foam sclerotherapy in the First Affiliated Hospital of Hebei Medical University from June 2014 to December 2015 were retrospectively analyzed.And the dosage of foam sclerotherapy and the healing time of ulcer were observed in different groups of patients.Results There was no significant difference in the recurrent time among the patients with three different surgical methods(P>0.05).In the superficial and perforating veins treatment group,the amount of foam was significantly larger than that in the superficial vein group or the perforating vein group(P<0.05).Ulcer healing rate of the C5 group was significantly different from that of the C6 group(P<0.05).The ulcer healing time was not significantly different between the patients with different genders in the 3 groups(P>0.05).Body mass index and age were positively associated with ulcer healing time(P<0.05).The incidence of superficial thrombophlebitis as the common post-sclerotherapical complication was 11.1%.The average amount of foam sclerosing agent used was larger in the patients with superficial thrombophlebitis than in the patients without thrombophlebitis(P<0.05).The rate of complete or partial recanalization of diseased vessels was 20.0%at the end of 12-month follow-up.Conclusions Ultrasound-guided foam sclerotherapy in treatment of operated leg ulcer recurrence is effective and convenient with quick recovery and few postoperative complications.