双侧下肢静脉曲张同期射频闭合的初步临床研究

Early study of one stage radiofrequency endovenous ablation on both sides of lower extremity varicosis

目的初步评价双侧下肢静脉曲张予以同期射频闭合(RFA)处理的早期临床疗效。方法回顾性分析2017年6月至2019年6月浙江省人民医院血管外科RFA治疗大隐静脉曲张的820例(1180条患肢)患者资料,根据患肢处理情况分为单侧组(n=460)与双侧组(n=360),比较两组住院时间、术后疼痛评分、术后并发症、治疗费用等的差异并超声随访大隐静脉主干闭合效果。结果单侧组住院时间较双侧组短,差异有统计学意义(t=18.31,P<0.01)。双下肢分期处理费用高于同期处理,差异有统计学意义(t=11.78,P<0.01)。大隐静脉RFA术后并发症发生率低,随访期间单侧组与双侧组两组并发症发生率差异无统计学意义(P均>0.05),超声随访显示大隐静脉主干闭合率为100%。结论RFA是治疗大隐静脉曲张的有效方式,早期闭合效果满意,双侧同期射频闭合大隐静脉曲张可显著降低患者治疗费用且术后并发症发生率未增加。

Objective To evaluate early effect of one stage endovenous radiofrequency ablation(RFA)on both sides of lower extremity varicose veins.Methods The data of 820 cases(1180 limbs)underwent RFA from June 2017 to June 2019 in Department of Vascular Surgery,Zhejiang Province People's Hospital were analyzed retrospectively.Enrolled patients were divided into single-limb group(n=460)and double-limb group(n=360)according to treated limbs.The differences in length of hospital stay,postoperative pain,postoperative complications,and treatment cost were compared between the two groups.The great saphenous vein occlusion rate was followed up by ultrasound.Results The hospital stay of the single-limb group was significantly shorter than that of the double-limb group(t=18.31,P<0.01).The cost of treatment by stages is significantly higher than that in one stage(t=11.78,P<0.01).The postoperative complication incidence after RFA was low,but there was no significant difference between the two groups(all P>0.05).The great saphenous vein occlusion rate was 100%according to the follow-up of ultrasound.Conclusion RFA is an effective treatment for lower extremity varicose veins with good short-term occlusion of great saphenous vein.One stage RFA on both sides of lower extremity varicose veins reduce treatment cost significantly without increasing the postoperative complication incidence.