超声引导下局部浸润麻醉在静脉腔内射频闭合术治疗大隐静脉曲张中的临床应用

The clinical application of ultrasound-guided local anesthesia in radionfrequency endovenous obliteration in treatment of great saphenous vein varices

目的探讨超声引导下利用局部浸润麻醉方式行静脉腔内射频闭合术(radiofrequency endovenous obliteration,RFO)治疗大隐静脉曲张(great saphenous vein varices,GSV)的优势。方法回顾性分析2015年6月至2018年12月期间甘肃省中医院收治的350例GSV患者。按照采用的不同麻醉方式分为观察组和对照组2组,每组175例。观察组采用局部浸润麻醉下RFO,对照组采用椎管内麻醉下RFO。比较2组患者麻醉即刻、术中、术后即刻、术后12 h及术后24 h的疼痛视觉模拟评分(visual analogue scale,VAS);比较2组患者的手术指标、术后恢复时间、满意度及术后并发症发生情况。结果与对照组比较,观察组患者麻醉即刻的VAS评分低(P<0.05),术中的VAS评分高(P<0.05),且手术时间、术后首次下地活动时间、恢复正常行走时间、麻醉相关并发症发生率及排尿障碍发生率均短于(或低于)对照组(P<0.05);而满意率高于对照组(P<0.05)。2组患者术后12 h及24 h的VAS评分,以及麻醉肿胀液量、术中出血量、术后住院时间、泌尿系感染发生率、切口感染发生率及深静脉血栓发生率比较差异均无统计学意义(P>0.05)。结论在局部浸润麻醉下可安全地行RFO治疗GSV,患者可早期下床活动,麻醉相关并发症发生率降低,促进患者早日康复。

Objective This study is designed to explore the indications,clinical pathway,and benefits of ultrasound-guided local anesthesia in radiofrequency endovenous obliteration(RFO)for great saphenous vein varices(GSV).Methods A total of 350 patients diagnosed with GSV were divide into observation group(n=175)and control group(n=175).Patients in the observation group underwent local anesthesia RFO,and patients in the control group underwent intravertebral anesthesia.Comparion in the visual analogue scale pain scores(VAS)when anesthesia and after surgery,operative indexes,recovery time,satisfaction,and complications were performed.Results Compared with the control group,the VAS score with anesthesia time were lower(P<0.05),while in the surgery were higher(P<0.05),as well as the operative time,the first time for underground activity,normal activity time,incidences of complication of anesthesia and urinary were shorter(P<0.05),and the satisfaction rate was higher(P<0.05).There was no difference in the pain score of 12 h and 24 h after surgery,blood loss,volume of anesthetic swelling fluid,postoperative hospitalization,incidences of urinary tract infection,incisional infection,and deep vein thrombosis(P>0.05).Conclusions The RFO is feasible and safe after local anaesthesia.It can decrease the complication of anesthesia,that will promote the patient soon to be restored to health.