大隐静脉高位结扎术联合静脉腔内激光治疗下肢静脉曲张的临床效果

Clinical effect of high saphenous vein ligation combined with intravenous laser in the treatment of varicose veins of lower extremities

目的探讨大隐静脉高位结扎术联合静脉腔内激光治疗下肢静脉曲张的临床效果。方法选取2017年11月至2020年11月大同市第三人民医院普外科收治的281例下肢静脉曲张患者作为研究对象,根据患者就诊顺序将其编号,按照编号单双数分为对照组(n=141)及观察组(n=140),对照组采用大隐静脉高位结扎及剥脱进行治疗,观察组采用大隐静脉高位结扎联合静脉腔内激光治疗,随访6个月,比较两组患者治疗效果、慢性静脉功能不全问卷(CIVIQ)评分及复发率,比较两组患者手术相关指标、术后并发症发生率。结果观察组的浅表溃疡愈合率高于对照组,差异有统计学意义(P<0.05)。观察组的手术总用时及住院总时间短于对照组,术中出血量少于对照组,各并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组患者术前CIVIQ评分比较,差异无统计学意义(P>0.05)。术后6个月,两组患者CIVIQ评分高于术前,且观察组CIVIQ评分高于对照组,差异有统计学意义(P<0.05)。结论静脉腔内激光联合大隐静脉高位结扎术治疗下肢静脉曲张可提高患者治疗效果,缩短手术时间及住院时间,降低术中出血量,同时进一步改善患者预后。

Objective To investigate the clinical effect of high saphenous vein ligation combined with intravenous laser in the treatment of varicose veins of the lower extremities.Methods A total of 281 patients with varicose veins of the lower extremities admitted to the Department of General Surgery of the Third People′s Hospital of Datong City from November 2017 to November 2020 were selected as research objects.The patients were numbered according to the order in which they visited,and they were divided into the control group(n=141)and the observation group(n=140)according to the odd and even numbers.The control group was treated with high saphenous vein ligation and stripping,and the observation group was treated with high saphenous vein ligation combined with intravenous laser treatment.The two groups were followed up for 6 months.Treatment effect,chronic venous insufficiency questionnaire(CIVIQ)score,recurrence rate,surgery-related indicators and the incidence of postoperative complications were compared between the two groups.Results The superficial ulcer healing rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The total operation time,total hospital stay of the observation group were shorter than those of the control group,intraoperative blood loss was less than that of the control group,and the incidence of complications were lower than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in the preoperative CIVIQ score between the two groups(P>0.05).At 6 months after operation,the CIVIQ score of the two groups was higher than that before operation,and the CIVIQ score of the observation group was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion Intravenous laser combined with high saphenous vein ligation for the treatment of varicose veins of the lower extremities can improve the treatment effect of patients,shorten the operation time and hospital stay,reduce the amount of intraoperative blood loss,and further improve the patients′prognosis.