激光治疗与传统手术治疗大隐静脉曲张的临床效果比较研究

Comparative Study on the Clinical Effect of Laser Therapy and Traditional Surgery for Varicose Great Saphenous Vein

目的:比较激光治疗与传统手术治疗大隐静脉曲张的临床效果。方法:选取2017年6月-2018年11月宜春市人民医院收治的大隐静脉曲张患者62例,采用掷硬币的方法将其分为对照组(n=30)和观察组(n=32),对照组行传统大隐静脉高位结扎联合点状抽剥术,观察组采用大隐静脉高位结扎联合腔内激光治疗。比较两组手术时间、切口长度、出血量、下床活动时间以及住院时间;比较两组慢性静脉功能不全问卷(CIVIQ)评分;比较两组术后并发症发生情况,以及随访12个月内溃疡愈合、色素沉着减退以及复发情况。结果:两组术后溃疡愈合率、色素沉着减退率及复发率比较,差异均无统计学意义(P>0.05);观察组手术切口长度短于对照组,术中出血量少于对照组,手术时间短于对照组,差异均有统计学意义(P<0.05);观察组术后下床活动时间早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05);观察组术后CIVIQ评分中疼痛、社会活动、体能、精神心理以及总分均明显高于对照组,差异均有统计学意义(P<0.05);观察组术后并发症发生率为9.38%,低于对照组的40.00%,差异有统计学意义(P<0.05)。结论:与传统手术相比,高位结扎联合腔内激光治疗大隐静脉曲张,具有创伤小、术后恢复快,同时术后并发症发生率低等优点。

Objective:To compare the clinical effect of laser therapy and traditional surgery for varicose great saphenous vein.Method:A total of 62 patients with varicose great saphenous vein who were admitted to Yichun People’s Hospital from June 2017 to November 2018 were selected,they were divided into control group(n=30)and observation group(n=32)by coin tossing method.The control group received traditional high ligation of the great saphenous vein combined with point extraction,while the observation group received high ligation of the great saphenous vein combined with intracavitary laser treatment.The operation time,incision length,intraoperative blood loss,leaving bed time,hospitalization time,score of chronic venous insufficiency questionnaire(CIVIQ),occurrence of postoperative complications,ulcer healing within 12 months after follow-up,hypopigmentation and recurrence were compared between the two groups.Result:There were no significant differences in postoperative ulcer healing rate,hypopigmentation rate or recurrence rate between the two groups(P>0.05).The surgical incision length in observation group was shorter than that in control group,intraoperative blood loss was less than that in control group,and operation time was shorter than that in control group(P<0.05).The postoperative leaving bed time in observation group was earlier than that in control group,and hospitalization time was shorter than that in control group(P<0.05).In CIVIQ,scores of pain,social activity,physical fitness and mental psychology,and total score in observation group were significantly higher than those in control group(P<0.05).The incidence of postoperative complications in observation group was 9.38%,lower than 40.00%in control group(P<0.05).Conclusion:Compared with traditional surgery,high ligation combined with intracavitary laser in the treatment of varicose great saphenous vein has the advantages of quick recovery after minor trauma and low incidence of postoperative complications.