大隐静脉高位结扎联合点式剥脱术对大隐静脉曲张患者术后复发和应激反应的影响

Effect of High Ligation of Great Saphenous Vein Combined with Point Stripping on Recurrence and Stress Response of Patients with Great Saphenous Varicose Vein after Operation

目的:探讨大隐静脉高位结扎联合点式剥脱术治疗大隐静脉曲张的临床疗效,并探讨其对患者术后复发和应激反应的影响。方法:选取2014年9月~2017年6月期间我院收治的大隐静脉曲张患者200例,按随机数字表法分为对照组(100例)和研究组(100例),其中对照组给予大隐静脉高位结扎联合传统剥脱术治疗,研究组给予大隐静脉高位结扎联合点式剥脱术治疗。比较两组术后4周的临床疗效,记录并比较两组患者手术时间、住院时间、下床活动时间、术中出血量,比较两组术前、术后3 d应激反应指标变化,观察两组并发症及复发情况。结果:研究组术后4周临床总有效率为97.00%,高于对照组的76.00%(P<0.05)。研究组患者手术时间、住院时间、下床活动时间均较对照组短,术中出血量较对照组少(P<0.05)。两组患者术后3 d白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)水平均较术前升高,但研究组低于对照组(P<0.05)。研究组术后并发症总发生率、复发率低于对照组(P<0.05)。结论:大隐静脉高位结扎联合点式剥脱术治疗大隐静脉曲张疗效确切,可促进患者的恢复,降低患者的复发率,机体应激反应较小,且安全性较好,具有一定的临床应用价值。

Objective: To explore the clinical effect of high ligation of great saphenous vein combined with point stripping in the treatment of varicose great saphenous vein, and to explore its influence on the recurrence and stress response of patients after operation.Methods: A total of 200 patients with varicose great saphenous vein, who were admitted to the First Affiliated Hospital of Xinjiang Medical University from September 2014 to June 2017, were selected and were randomly divided into control group(100 cases) and study group(100 cases). The control group was treated with high ligation of great saphenous vein combined with traditional stripping. The study group was treated with high ligation of great saphenous vein combined with point stripping. The clinical efficacy of the two groups was compared 4 weeks after operation. The operation time, hospitalization time, time to get out of bed and amount of bleeding during the operation were recorded and compared between the two groups. The changes of stress response indexes before operation and 3 days after operation were compared between the two groups. Complications and recurrence were observed in the two groups. Results: The total effective rate of the study group was 97.00% 4 weeks after operation, which was significantly higher than that(76.00%) of the control group(P<0.05). The operation time, hospitalization time and out of bed activity time in the study group were shorter than those in the control group, and the amount of bleeding during the operation was less than that in the control group(P<0.05). The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) and nitric oxide(NO) in the two groups increased 3 days after operation, but the above indexes in the study group were lower than those in the control group(P<0.05). The total incidence and recurrence rate of complications in the study group were lower than those in the control group(P<0.05). Conclusion: High ligation of great saphenous vein combined with point stripping is effective in the treatment of varicose great saphenous vein.It can promote the recovery of patients, reduce the recurrence rate of patients, with small stress response of the body, good safety, and certain clinical application value.