新型微波导管腔内热消融术与激光导管腔内热消融术治疗慢性下肢静脉功能不全的有效性及安全性

Efficacy and safety of new microwave catheter and laser catheter endovascular thermal ablation in the treatment of chronic lower extremity venous insufficiency

目的探讨传统的激光导管腔内热消融术与新型微波导管腔内热消融术治疗慢性下肢静脉功能不全的有效性及安全性。方法收集2021年1—6月河北医科大学第一医院收治的56例慢性下肢静脉功能不全患者的临床资料,采用交互式网络相应系统将患者随机分为微波导管组(实施新型微波导管腔内热消融术)与激光导管组(实施激光导管腔内热消融术),各28例。观察并比较两组患者的围手术期指标(手术时间、术中出血量及住院时间),术前、术后1个月及术后3个月的静脉临床严重程度评分(VCSS)。比较两组患者术后3个月大隐静脉主干再通率、术后1周皮下淤血及皮下硬结发生率。结果两组患者的手术时间、术中出血量及住院时间比较,差异均无统计学意义(P>0.05)。两组患者术后1、3个月的VCSS均低于本组术前,差异均有统计学意义(P<0.05)。两组患者术前、术后1个月及术后3个月的VCSS比较,差异均无统计学意义(P>0.05)。两组患者术后3个月大隐静脉主干再通率以及术后1周皮下淤血、皮下硬结的发生率比较,差异均无统计学意义(P>0.05)。结论新型微波消融导管腔内热消融术与激光导管腔内热消融术治疗慢性下肢静脉功能不全的有效性及安全性均较高,值得临床应用。

Objective To investigate the efficacy and safety of traditional laser catheter endovascular thermal ablation and new microwave catheter endovascular thermal ablation in the treatment of chronic lower extremity venous insufficiency.Method The clinical data of 56 patients with chronic lower extremity venous insufficiency admitted to the First Hospital of Hebei Medical University from January to June 2021 were collected.The patients were randomly divided into the microwave catheter group(implementing the new microwave catheter endovascular thermal ablation)and the laser catheter group(implementing the laser catheter endovascular thermal ablation)using the interactive network corresponding system,with 28 cases in each group.The perioperative indicators(operation time,intraoperative blood loss,and hospitalization time),and the venous clinical severity score(VCSS)before operation,one month after the operation,and three months after the operation were observed and compared between the two groups.The recanalization rate of the great saphenous vein trunk at three months after the operation and the incidence rate of subcutaneous congestion and subcutaneous induration at one week after the operation were compared between the two groups.Result There were no statistically significant differences in operation time,intraoperative blood loss,and hospital stay between the two groups(P>0.05).The VCSS at one month and three months after the operation in the two groups were lower than those before the operation in the same group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in VCSS between the two groups before the operation,one month after the operation,and three months after the operation(P>0.05).There was no statistically significant difference in the recanalization rate of the great saphenous vein trunk three months after the operation and the incidence rate of subcutaneous congestion and subcutaneous induration one week after the operation between the two groups(P>0.05).Conclusion The new microwave catheter endovascular thermal ablation and laser catheter endovascular thermal ablation have high efficacy and safety in the treatment of chronic lower extremity venous insufficiency,and are worthy of clinical application.