超声实时监控下腔内激光闭合治疗大隐静脉曲张的效果

Effect of endovenous laser therapy under real-time monitoring of ultrasound on great saphenous vein varicose

目的分析超声实时监控下腔内激光闭合治疗(EVLT)在大隐静脉曲张中的治疗效果。方法选取2017年3月至2018年3月大隐静脉曲张患者57例(共69条患肢),在超声实时监控下行EVLT,术后1周、1、3、6、12个月随访,均行超声检查。结果术后55条患肢痊愈,其余14条患肢的CEPA分级不同程度下降。术后发生血栓性静脉炎2例,给予消炎止痛治疗,均于术后2周恢复正常;内踝处麻木1例,2个月后自行恢复正常;小腿属支静脉曲张复发1例,为术后2个月出现,复查超声显示对应穿通支存在血流信号,嘱患者继续穿戴弹力袜,病情未再进展。术后超声复查均未见大隐静脉主干存在血流信号,无血栓性静脉炎、皮肤烧灼、下肢深静脉血栓、肺栓塞等并发症。结论超声实时监控下EVLT治疗大隐静脉曲张,是一种微创、安全、有效、美观的治疗方法。

Objective To analyze the effect of endovenous laser therapy(EVLT)under real-time monitoring of ultrasound on great saphenous vein varicose.Methods Fifty-seven cases(69 limbs)of great saphenous vein varicose from March 2017 to March 2018 were selected,patients were treated by EVLT under real-time monitoring of ultrasound.Postoperative follow-up with ultrasonography was given for 1 week,1,3,6 and 12 months.Results Fifty-five limbs recovered after operation,and the CEPA grade of the other 14 limbs decreased in varying degrees.Two cases of thrombophlebitis occurred after operation,which were treated with anti-inflammatory and analgesic therapy,all recovered to normal at 2 weeks after operation;one case of numbness in the medial malleolus occurred and recovered to normal 2 months later;one case of calf brancn vein varicose relapsed during 2 months after operation,the reexamination ultrasound showed that there was blood flow signal in the corresponding perforating branch,and the patient was asked to continue wearing elastic socks and there was no further progress.There were no blood signals in the great saphenous vein and no complications such as thrombophlebitis,skin burning,deep vein thrombosis and pulmonary embolism at the time of postoperative ultrasound reexamination.Conclusion EVLT under real-time monitoring of ultrasound for great saphenous vein varicose is a minimally invasive,safe,effective and aesthetic treatment.