大隐静脉曲张术后梯度压力不同治疗时长效果比较

Effects of different treatment duration of gradient pressure after great saphenous vein varicotomy

目的观察大隐静脉曲张术后患者采用不同压力治疗方案的效果。方法选取2021年6月~2022年12月合肥市第二人民医院行静脉曲张手术患者150例,随机数表法分为3组,每组50例。患者术后以弹力绷带加压24 h后序贯使用梯度压力袜(GCS),A组患者连续7 d,每天24 h使用GCS,共1周。B组患者在连续使用7 d后改为白天压力治疗12 h以上,共2周。C组患者在连续使用7 d后改为白天压力治疗12 h以上,共4周。比较3组患者术后1、2、4周的疼痛程度、小腿周径差值。比较3组并发症发生情况。对术前及术后3个月的下肢静脉曲张生活质量相关量表静脉症状调查问卷(HASTI)、疾病特异性生活质量调查(AVVQ)进行比较。结果C组剔除1例脱落病例。3组术后1周、2周、4周VAS评分两两比较,组间差异无统计学意义(P>0.05)。术后第1周、第4周3组间小腿周径差值两两比较,差异无统计学意义(P>0.05);术后第2周A组小腿周径差值高于B组和C组,组间差异均有统计学意义(P<0.05)。3组间并发症发生率、HASTI及AVVQ评分两两比较,差异无统计学意义(P>0.05)。结论大隐静脉曲张术后辅助压力治疗有助于患者术后恢复。术后GCS压力治疗2周可明显减轻疼痛、肿胀,持续超过2周并未给术后疼痛肿胀的缓解、并发症的预防及短期生活质量提高带来益处。

Objective To observe the effect of different pressure treatment schemes on patients with great saphenous vein varicosity after operation.Methods 150 patients undergoing varicose vein surgery admitted to our hospital from June 2021 to December 2022 were divided into 3 groups,with 50 patients in each group.Patients in group A were treated with gradient compression stockings(GCS)after 24 hours of postoperative compression with elastic bandages.GCS was used 24 hours a day for 7 consecutive days for a total of 1 week.Group B patients underwent daytime pressure therapy for more than 12 hours after continuous use for 7 days,for a total of 2 weeks.Group C patients underwent daytime pressure therapy for more than 12 hours after continuous use for 7 days,for a total of 4 weeks.Compare the pain levels and leg circumference differences among three groups of patients at 1,2,and 4 weeks after surgery.Compare the incidence of complications among three groups.Compare the heaviness achiness swelling throbbing itching(HASTI) and assessment disease specific quality of life(AVVQ) before and 3 months after surgery.Results Group C excluded 1 dropout case.There was no statistically significant difference in VAS scores between the three groups at 1 week,2 weeks,and 4 weeks after surgery(P>0.05).At the first and fourth weeks after surgery,the difference in leg circumference between the three groups was compared,and there was no statistically significant difference(P>0.05).At the second week after surgery,the difference in leg circumference between group A was higher than that between group B and group C,and the differences between the groups were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications,HASTI and AVVQ scores between the three groups(P>0.05).Conclusion The auxiliary pressure treatment after great saphenous vein varicose surgery is helpful to the postoperative recovery of patients.Postoperative GCS pressure therapy for 2 weeks can significantly reduce pain and swelling,but lasting for more than 2 weeks does not bring benefits to the relief of postoperative pain and swelling,prevention of complications,and improvement of short-term quality of life.