超声和DSA引导下泡沫硬化剂治疗下肢静脉曲张的临床对比研究

Clinical Comparative Study of Ultrasound-guided and DSA-guided Foam Sclerotherapy in Varicose veins

目的探讨超声引导和数字减影血管造影(digital subtraction angiography,DSA)引导下泡沫硬化剂治疗C2~C4级下肢静脉曲张的临床疗效和两种治疗方式的差异性。方法统计2018年1月至2019年6月在我科收治的下肢静脉曲张C2~C4级患者,治疗方式均按患者意愿自主选择,分为超声治疗组和DSA治疗组。超声治疗组76例患者,83条患肢;DSA治疗组92例患者,104条患肢。统计分析两组患者术中泡沫硬化剂使用剂量、术后并发症发生率、术后12个月复发率、术前及术后VCSS评分。结果两组并发症发生率、血栓性浅静脉炎发生率、12个月复发率比较无明显差异(P>0.05);而术中每条患肢平均泡沫硬化剂使用剂量超声治疗组(12.44±0.75)mL低于DSA治疗组(4.53±0.67)mL,比较有明显差异(P<0.05)。超声治疗组和DSA治疗组手术前VCSS评分分别为(6.38±2.92)分和(7.13±2.57)分,比较无明显差异(P>0.05),DSA治疗组术后VCSS评分(3.18±0.15)分低于超声治疗组(3.43±0.26)分,比较有明显差异(P<0.05)。结论超声引导和DSA引导下单纯泡沫硬化剂治疗下肢静脉曲张是安全、有效的治疗方案。对于C2~C4级下肢静脉曲张患者,超声引导下的泡沫硬化剂治疗是更合理的治疗方案。

Objective The study mainly investigated the clinical effectiveness and the difference between ultrasound-guided and DSA-guided foam sclerotherapy in varicose veins of C2-C4.Methods According to statistics,patients with lower extremity varicose veins C2-C4 who were admitted to our department from January 2018 to June 2019,the treatment methods are selected according to the patient's wishes,and they were divided into ultrasound treatment group and DSA treatment group.There were 76 patients in the ultrasound treatment group,with 83 affected limbs;92 patients in the DSA treatment group,with 104 affected limbs.Statistical analysis of the intraoperative foam sclerosing agent dosage,postoperative complication rate,recurrence rate at 12 months after surgery,and preoperative and postoperative VCSS scores of the two groups of patients.Results There was no significant difference in the incidence of complications,superficial thrombophlebitis,and 12-month recurrence rate between the two groups(P>0.05);but the average foam sclerosing agent dosage of each affected limb in the ultrasound treatment group(12.44±0.75)mL was lower than that in the DSA treatment group(4.53±0.67)mL,which was significantly difference(P<0.05).The preoperative VCSS scores of the ultrasound treatment group and the DSA treatment group were(6.38±2.92)points and(7.13±2.57)points,respectively,there was no significant difference(P>0.05).The postoperative VCSS score of the DSA treatment group was low(3.18±0.15)points,in the ultrasound treatment group(3.43±0.26)points,there was a significant difference(P<0.05).Conclusion The ultrasound-guided and DSA-guided foam sclerotherapy were safe and effective treatment for varicose veins.Compared with DSA-guided foam sclerotherapy,ultrasound-guided foam sclerotherapy was a more reasonable treatment for the patients with varicose veins of C2-C4.