腔内射频消融联合泡沫硬化剂治疗下肢静脉曲张的临床疗效观察

Clinical efficacy of endovenous radiofrequency ablation combined with foam sclerosing agent in the treatment of lower extremity varicose veins

目的探讨腔内射频消融联合泡沫硬化剂治疗下肢静脉曲张的疗效。方法收集南昌大学第二附属医院2020—2022年间所有行手术治疗的下肢静脉曲张患者资料。将使用腔内射频导管对大隐静脉主干进行闭合,对小腿和局部细小的浅静脉进行聚多卡醇泡沫硬化剂治疗的366例患者,共计497条肢体纳入观察组,将大隐静脉高位结扎和抽剥治疗的245例患者,共计326条肢体纳入对照组,对比分析两组患者的术中出血量、手术时长、住院时长,手术并发症,治疗相关费用以及随访情况等。结果相较于对照组,观察组患者术中出血量更少,手术时间及住院时长更短,术后皮下瘀血、隐神经损伤、血栓性浅静脉炎和切口感染愈合不良发生率更低,差异有统计学意义(P<0.05),静脉曲张复发率相当,差异无统计学意义(P>0.05),但总费用相对较高(P<0.05)。结论与传统手术相比,腔内射频消融联合聚多卡醇泡沫硬化剂治疗下肢静脉曲张的疗效确切、创伤更小、恢复更快、时间成本更低、并发症更少,并且在追求美观化方面也有很大的优势。

Objective To investigate the therapeutic efficacy of endovenous radiofrequency ablation(RFA)in combination with foam sclerosing agent in the treatment of lower extremity varicose veins.Methods The clinical data of all patients with lower extremity varicose veins,who underwent surgical treatment in the Second Affiliated Hospital of Nanchang University from 2020 to 2022,were reviewed.The observation group underwent endovenous radiofrequency catheter closure for the great saphenous vein and foam sclerotherapy for small and locally superficial veins,including 366 patients and a total of 497 limbs.The control group underwent high ligation and stripping of the great saphenous vein,including 245 patients and a total of 326 limbs.The intraoperative blood loss,operation time,length of hospital stay,surgical complications,treatment related costs and follow-up were compared between the two groups.Results Compared with control group,the intraoperative blood loss was lower,the operation time and length of hospital stay were shorter,the incidence of postoperative subcutaneous congestion,saphenous nerve injury,superficial thrombophlebitis and wound infection poor healing were lower in observation group,the differences were statistically significant(P<0.05).While the variceal recurrence rates were similar(P>0.05),the total cost was relatively higher in observation group(P<0.05).Conclusion Compared with traditional surgery,the combination of endovenous RFA and foam sclerotherapy offers precise treatment effect,less trauma,faster recovery,lower time cost,fewer complications,and great advantages in the pursuit of aesthetics.