超声引导下腔内射频消融与泡沫硬化剂注射治疗下肢静脉性溃疡的对照研究

Control study of ultrasound guided endovenous radiofrequency ablation and foams clerotherapy for venous leg ulcers

目的评价超声引导下腔内射频消融(RFA)与泡沫硬化剂注射(FS)治疗下肢静脉性溃疡的安全性及临床疗效。方法选择2018年1月至2018年12月期间入住浙江大学医学院附属邵逸夫医院的患者90例,随机平均分成RFA组45例,51条患肢,采用RFA治疗,FS组45例,54条患肢,采用FS治疗。两组进行安全性及临床疗效的对比研究。结果 RFA组术后静脉临床严重程度评分(VCSS)(4.51±1.45)分与FS组术后VCSS(5.13±1.93)分比较,差异无统计学意义(t=-1.851,P> 0.05)。RFA组术后VCSS与术前(12.78±3.75)分比较,差异有统计学意义(t=24.964,P <0.05);FS组术后VCSS与术前(12.69±3.68)分比较,差异有统计学意义(t=29.852,P <0.05)。两组术后均无严重并发症,且所有并发症均于术后1年内消失。两组术后并发症方面比较,差异无统计学意义(χ^(2)=0.081, P> 0.05)。RFA组术后穿通静脉闭合率与FS组比较,差异有统计学意义(96.07%vs 79.63%,χ^(2)=5.113,P <0.05)。结论两种手术方式均有安全性,RFA疗效优于FS。

Objective To evaluate the safety and clinical efficacy of ultrasound guided endovenous radiofrequency ablation(RFA) and foam sclerotherapy(FS) in the treatment of venous leg ulcers. Methods From January 2018 to December 2018,90 patients from Sir Run Run Shaw Hospital were randomly divided into two groups on average by Excel table. There were 45 patients with 51 limbs in RFA group, treated by RFA, and 45 patients with 54 limbs in FS group, treated by FS. The safety and clinical efficacy of the two groups were compared. Results There was no significant difference in postoperative venous clinical severity score(VCSS) between RFA group(4.51±1.45) and FS group(5.13±1.93)(t=-1.851, P > 0.05). The postoperative VCSS in RFA group was significantly lower than preoperative VCSS(12.78±3.75)(t=24.964, P < 0.05). The postoperative VCSS of FS group was significantly lower than preoperative VCSS(12.69±3.68)(t=29.852, P < 0.05). There were no serious complications in both groups and all complications disappeared within one year after operation. There was no significant difference in postoperative complications between the two groups(χ^(2)=0.081, P > 0.05).There was significant difference between RFA group and FS group in closure rate of perforating veins after operation(96.07% vs 79.63%, χ^(2)=5.113, P < 0.05). Conclusion RFA and FS are both safe, but the clinical efficacy of RFA is better than that of FS.