小切口结合点状剥脱术治疗下肢静脉曲张

The treatment of varicose veins of lower extremities by using mini incision combined with minimally invasive point endarterectomy

目的观察小切口结合点状剥脱术对下肢静脉曲张治疗效果及安全性。方法选择2016年6月—2021年6月在本院住院治疗的86例下肢静脉曲张患者作为研究对象,其中实施小切口结合点状剥脱术的46例患者作为观察组,采用传统大隐静脉高位结扎剥脱术的40例患者作为对照组。记录并比较两组患者围手术期指标、术后并发症及术后下肢静脉曲张复发情况。结果观察组手术时间为(1.16±0.02)h、术中出血量为(15.56±10.47)ml,均显著低于对照组的[(1.58±0.91)h和(50.56±14.68)ml],差异均有显著统计学意义(P<0.01)。观察组术后住院时间为(3.74±2.14)d,并发症发生率为3例(6.52%),低于对照组的(6.38±3.58)d和14例(35.0%),差异具有统计学意义(P<0.05)。术后,观察组的VAS评分均显著低于对照组(P<0.01)。观察组的VCSS评分和对照组相比较,差异无统计学意义(P>0.05)。对照组患者术后6个月内下肢静脉曲张复发率(2例,5.00%)与观察组(0例,0.00%)相比,差异无统计学意义(P>0.05)。结论小切口联合点状剥脱术可改善下肢静脉曲张患者围手术期指标,降低术后痛感及各种并发症的发生风险,安全性较传统手术更高,值得临床推广应用。

Objective To observe the efficacy and safety of small incision combined with minimally invasive point-endarterectomy in the treatment of lower extremity varicose veins.Methods Eighty-six patients diagnosed as varicose veins of lower extremity who underwent surgery in inpatient department of the hospital from June 2016 to June 2021 were recruited as study subjects.The 46 patients received small incision combined with minimally invasive point-endarterectomy were in the observation group,and the other 40 patients received traditional great saphenous vein high ligation and stripping were in the control group.Perioperative indicators,postoperative complications and recurrence of varicosity of lower extremities in the two groups were noted and evaluated.Results The operation time(0.52±0.02h vs 1.58±0.91h)and intraoperative blood loss(37.54±10.47 mL vs 62.50±14.68mL)of the observation group were significantly less than those of the control group(P<0.01).Comparing with the control group,the hospital stay in the observation group was shortened(7.74±2.14d vs 9.38±3.58d),the incidence of complications in the observation group were lower(3 cases,6.52%)vs(14 cases,35.0%),P<0.05.After surgery,the VAS scores in the observation group were significantly lower than those in the control group(P<0.01).There was no significant difference in VCSS score between the observation group and the control group(P>0.05).There was no statistically significant difference in the recurrence rate of varicosity of lower extremities between the control group(2 cases,5.00%)and the observation group(0 cases,0.00%)within 6 months after varicose veins procedures(P>0.05).Conclusions The surgical therapy of mini incision combined with minimally invasive point-endarterectomy could improve the perioperative indicators of patients with varicosity of lower extremities,reduce postoperative pain and the risk of various postoperative complications,its safety is higher than that of traditional surgery,which is worthy of clinical application.