腔内射频消融术联合硬化剂注射术及点状剥脱术治疗大隐静脉曲张的临床效果

Clinical effecacy of radiofrequency ablation combined with foam sclerotherapy and punctate stripping in treatment of great saphenous varicose veins

目的探讨腔内射频消融术联合硬化注射术及点状剥脱术治疗大隐静脉曲张的临床效果。方法选取2014年1月至2020年6月北京市第二医院外科收治的80例大隐静脉曲张手术患者,采用腔内射频消融术联合硬化剂注射术及点状剥脱术的患者38例,为观察组;采用大隐静脉高位结扎剥脱术的患者42例,为对照组。比较两组术中出血量、手术时间、术后住院时间、术后疼痛视觉模拟评分(VAS)、术后并发症情况及静脉临床危重程度评分(VCSS)。结果观察组术中出血量少于对照组,手术时间、术后住院时间短于对照组,及术后24 h VAS评分低于对照组(P<0.05)。观察组术后皮下瘀斑及隐神经损伤发生率低于对照组(P<0.05)。两组切口感染发生率比较,差异无统计学意义(P>0.05)。两组均未发生血栓性浅静脉炎及深静脉血栓。术后随访1年,两组均无复发。两组术后1年VCSS评分较术前降低(P<0.05)。结论腔内射频消融联合硬化剂注射及点状剥脱术治疗大隐静脉曲张效果显著,可降低术中出血量,减少手术时间和住院时间,避免并发症的发生,加快术后康复。

Objective To explore the clinical efficacy of radiofrequency ablation combined with foam sclerotherapy and punctate stripping on treatment of great varicose veins.Methods A total of 80 patients with great saphenous varicose veins treated with Department of Surgery,Beijing Second Hospital from January 2014 to June 2020 were selected.A total of 38 patients treated with radiofrequency ablation combined with foam sclerotherapy and punctate stripping were as the observation group;42 patients treated with high ligation and stripping of great saphenous veins were as the control group.Intraoperative blood loss,operation time,postoperative hospital length of stay,visual analogue scale(VAS)score,postoperative complications and venous clinical severity score(VCSS)were compared in two groups respectively.Results The amount of intraoperative blood loss in the observation group was less than that in the control group,the operation time and postoperative hospital stay were shorter than that in the control group,and the 24 h postoperative VAS score was lower than that in the control group(P<0.05).The incidence of subcutaneous ecchymosis and saphenous nerve injury in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence of incision infection between the two groups(P>0.05).No superficial thrombophlebitis and deep vein thrombosis occurred in the two groups.After one year follow-up,there was no recurrence in both groups.VCSS scores of the two groups one year after surgery were lower than those before surgery(P<0.05).Conclusion Radiofrequency ablation combined with foam sclerotherapy and punctate stripping have a significant effect in the treatment of great saphenous varicose veins,which can reduce intraoperative blood loss,shorten operation time and hospital length of stay,reduce complications,and facilitate rapid postoperative recovery.