腔内射频消融术治疗下肢浅静脉曲张的临床疗效观察

Observation of clinical efficacy of endovenous radiofrequency ablation for superficial varicosis of lower limbs

目的探讨腔内射频消融术(RFA)治疗下肢浅静脉曲张的临床疗效。方法回顾性分析216例(236肢)下肢浅静脉曲张患者的临床资料,将行腔内RFA和大隐静脉高位结扎剥脱术治疗的患者分别设为观察组(106例)和对照组(110例)。比较两组患者手术时间、术中出血量、术后住院时间、术后24 h VAS评分和术后并发症情况,以及手术前后的CEAP分级、静脉临床严重程度评分(VCSS)、慢性静脉功能不全问卷(CIVIQ)评分情况。结果与对照组相比,观察组患者术中出血量少、术后住院时间短、术后24 h VAS评分低、并发症发生率低(均P<0.05),但两组手术时间差异无统计学意义(P>0.05)。术后1年,两组患者术后CEAP分级优于术前,VCSS低于术前,CIVIQ评分高于术前(均P<0.05),但两组比较差异均无统计学意义(均P>0.05);术后3个月,两组CIVIQ评分高于术前,且观察组评分高于对照组(均P<0.05)。结论腔内RFA治疗下肢浅静脉曲张患者,方法更简单、微创,并发症更少,围术期患者的体验更好,生活质量改善较好。

Objective To investigate the clinical efficacy of endovenous radiofrequency ablation(RFA)in the treatment of superficial varicosis of lower limbs.Methods The clinical data of 216 patients(236 limbs)with superficial varicosis of lower limbs were retrospectively analyzed.The patients undergoing endovenous RFA and high ligation and stripping of the great saphenous vein were assigned to observation group(106 cases)and control group(110 cases),respectively.The operative time,intraoperative bleeding volume,postoperative hospital stays,VAS score 24 hours after operation and postoperative complications,as well as the pre-and post-operative clinical-etiological-anatomical-pathological(CEAP)classification,venous clinical severity score(VCSS)and chronic venous insufficiency questionnaire(CIVIQ)scores were compared between the two groups.Results Compared with the control group,patients in the observation group had less intraoperative bleeding volume,shorter postoperative hospital stays,lower VAS score 24 hours after operation and incidence of postoperative complications(all P<0.05),but there was no statistically significant difference in operative time between the two groups(P>0.05).One year after operation,the CEAP classifications improved,the VCSS decreased,and the CIVIQ scores increased in both groups as compared to before operation(all P<0.05),but there were no statistically significant differences in the abovementioned indicators between the two groups(all P>0.05).The scores of CIVIQ were higher in both groups 3 months after operation than that before operation,and the scores in the observation group were higher than that in the control group(all P<0.05).Conclusion Endovenous RFA is a simple and minimally invasive method in the treatment of patients with superficial varicosis of lower limbs,with fewer complications,better perioperative experience and quality of life for patients.