大隐静脉高位结扎剥脱术治疗下肢静脉曲张术后并发症发生现状及影响因素分析

Analysis of Current Status and Influencing Factors of Postoperative Complications of Great Saphenous Vein High Ligation and Stripping for Treatment of Varicose Veins of the Lower Extremities

目的 探讨大隐静脉高位结扎剥脱术(high ligation and stripping,HLS)治疗下肢静脉曲张术后并发症发生现状及影响因素。方法 回顾性选取2020年5月—2022年5月闽清县总医院收治的96例行大隐静脉HLS治疗下肢静脉曲张患者的临床资料,观察术后1年内并发症发生情况,并根据患者术后是否发生并发症分为并发症组(n=31)及无并发症组(n=65)。单因素及多因素Logistic回归分析术后并发症发生的影响因素。结果 单因素分析结果提示,并发症组年龄≥60岁、合并糖尿病、术中切口数量≥7个及弹力袜穿戴依从性差占比高于无并发症组,术前血清白蛋白≥35 g/L占比低于无并发症组,差异有统计学意义(P均<0.05)。多因素Logistic回归分析结果提示,高龄(OR=3.796,P<0.05)、合并糖尿病(OR=3.589,P<0.05)、多术中切口数量(OR=4.471,P<0.05)及术后弹力袜穿戴依从性差(OR=3.636,P<0.05)均是影响大隐静脉HLS治疗下肢静脉曲张术后并发症发生的独立危险因素,高术前血清白蛋白≥35 g/L(OR=0.241,P<0.05)为影响大隐静脉HLS治疗下肢静脉曲张术后并发症发生的独立保护因素。结论 大隐静脉HLS治疗下肢静脉曲张术后并发症受多种因素影响,临床应据此提前制订针对性干预措施,降低术后并发症发生率,提高患者预后水平。

Objective To investigate the current situation and factors affecting the occurrence of postoperative complications after great saphenous vein high ligation and stripping(HLS) for the treatment of varicose veins of the lower extremities.Methods The clinical data of 96 cases of great saphenous vein HLS for varicose veins of the lower extremities admitted to Minqing General Hospital from May 2020 to May 2022 were retrospectively selected as the study objects to observe the occurrence of complications within 1 year after the operation,and the patients were divided into the complication group(n=31) and the group with no-complication(n=65) based on the occurrence of postoperative complications or not.Unifactorial and multifactorial logistic regression were used to analyze the factors influencing the occurrence of postoperative complications.Results The results of unifactorial analysis suggested that the proportion of age ≥60 years,combined diabetes mellitus,the number of intraoperative incisions ≥7 and poor compliance of elastic stocking wearing were higher in the complication group than in the no-complication group,and the proportion of preoperative serum albumin ≥35 g/L was lower than that in the no-complication group,and the differences were all statistically significant(all P<0.05).The results of multifactorial logistic regression analysis suggested that advanced age(OR=3.796,P<0.05),comorbid diabetes mellitus(OR=3.589,P<0.05),number of multiple intraoperative incisions(OR=4.471,P<0.05),and poor adherence to postoperative compression stocking wearing(OR=3.636,P<0.05) were all independent risk factors affecting the occurrence of postoperative complications in the treatment of varicose veins of the lower extremities with great saphenous vein HLS.High preoperative serum albumin ≥35 g/L(OR=0.241,P<0.05) was an independent protective factor affecting the occurrence of postoperative complications after great saphenous vein HLS for the treatment of varicose veins of the lower extremities.Conclusion The postoperative complications of great saphenous vein HLS for the treatment of varicose veins of the lower extremity are affected by a variety of factors,and the clinic should formulate targeted interventions in advance accordingly to reduce the incidence of postoperative complications and improve the prognosis of patients.