早期微创小切口大隐静脉高位结扎及剥脱术治疗静脉曲张并血栓性浅静脉炎患者的效果及安全性分析

Efficacy and Safety Analysis of Early Minimally Invasive Small Incision High Ligation and Extirpation of the Great Saphenous Vein in the Treatment of Varicose Veins Complicated with Superficial Thrombophlebitis

目的分析早期微创小切口大隐静脉高位结扎及剥脱术在静脉曲张并血栓性浅静脉炎(STP)治疗中的应用价值。方法选取2017年7月至2019年7月新郑市中医院收治的98例静脉曲张并STP患者,根据随机抽签法分为两组,各49例。传统组接受传统治疗,小切口组接受早期微创小切口大隐静脉高位结扎及剥脱术治疗。比较两组疗效、住院时间、术中出血量、下床时间、手术时间、使用抗生素时间、静脉临床严重程度评分(VCSS)及并发症发生率。结果小切口组治疗总有效率(97.96%)高于传统组(81.83%),住院时间、抗生素使用时间、首次下床活动时间较传统组短,术中出血量少于传统组,术后4周VCSS评分及并发症发生率较传统组低(P<0.05);小切口组手术时间与传统组比较,差异无统计学意义(P>0.05)。结论静脉曲张并STP患者行早期微创小切口大隐静脉高位结扎及剥脱术,能显著减少术中出血量,减轻病情,缩短康复时间,促进预后转归,且安全性高。

Objective To analyze the application value of early minimally invasive high ligation and extirpation of the great saphenous vein with small incision in the treatment of varicose veins complicated with superficial thrombophlebitis(STP).Methods A total of 98 patients with varicose veins complicated with STP admitted to Xinzheng Hospital of Traditional Chinese Medicine from July 2017 to July 2019 were selected and divided into 2 groups according to random drawing,49 cases in each group.The traditional group was treated with traditional treatment,while the small incision group was treated with early minimally invasive small incision high ligation and extirpation of the great saphenous vein.The efficacy,length of hospital stay,intraoperative blood loss,time out of bed,operation time,duration of antibiotic administration,venous clinical severity score(VCSS)and complication rate were compared between the two groups.Results The total effective rate of the small incision group(97.96%)higher than that of the traditional group(81.83%).The length of hospital stay,the time of antibiotic use,the first time of getting out of bed were shorter than that of the traditional group.The amount of intraoperative blood loss was less than that of the traditional group.The VCSS score and the incidence of complications were lower than that of the traditional group after surgery 4th week(P<0.05).There was no significant difference in the operation time between the small incision group and the traditional group(P>0.05).Conclusion Early minimally invasive small incision ligation and extirpation of the great saphenous vein in patients with varicose veins complicated with STP can significantly reduce the amount of intraoperative blood loss,alleviate the condition,shorten the recovery time,promote the prognosis,and have high safety.