VeinHavst术微创治疗与腔内激光消融术治疗大隐静脉曲张的疗效比较

Effect on Varicose Veins of Great Saphenous Vein:VeinHavst Minimally In⁃vasive Surgery vs.Endovascular Laser Ablation(EVLA)

目的比较静脉剥脱导管(vein harvester,VeinHavst)术微创治疗与腔内激光消融术(endovenous laser ablation,EVLA)治疗大隐静脉曲张的疗效。方法选取2021年4月至2023年1月,大隐静脉曲张患者100例,随机分为对照组和研究组,每组患者50例,对照组给予EVLA治疗,激光脉冲功率为12 W,时间为1 s,间隔1 s;研究组给予VeinHavst术微创治疗。比较两组围术期相关指标。治疗前和治疗后5d,记录两组患者慢性静脉功能不全(chronic venous insufficiency questionnaire,CIVIQ)评分、静脉曲张症状严重程度(abnormal venous vein severity score,AVVSS)评分、患肢静脉血流速度以及并发症发生情况。结果与对照组比较,研究组手术时间、住院时间更短(P<0.05),术中出血量、住院费用均少于对照组(P<0.05)。与治疗前比较,两组治疗后5 d CIVIQ评分升高(P<0.05),AVVSS评分降低(P<0.05)。与对照组比较,研究组治疗后5 d CIVIQ评分更高(P<0.05),AVVSS评分更低(P<0.05)。与治疗前比较,两组治疗后5 d腘静脉、股静脉、髂外静脉血流速度升高(P<0.05),且与对照组比较,研究组治疗后更高(P<0.05)。研究组并发症发生率(8.00%)低于对照组(24.0%),差异具有统计学意义(P<0.05)。结论与EVLA治疗大隐静脉曲张相比较,VeinHavst术微创治疗可有效缩短手术时间,减少术中出血量,减轻症状,改善静脉功能,加快患肢血流速度,降低并发症,促进快速康复。

Objective To compare the efficacy of minimally invasive vein harvester(VeinHavst)and endovenous laser ablation(EVLA)for varicose veins of the great saphenous vein.Methods A total of 100 patients suffered varicose veins of great saphenous vein and treated over the period from Apr.2021 to Jan.2023 were selected and randomly divided into a control group and a research group,50 patients in each group.The patients in the control group were given EVLA treatment with a laser pulse power of 12 W,time of 1s and interval of 1s.The patients in the study group were given VeinHavst minimally invasive treatment.Related perioperative indexes were compared between the two groups.For both groups,the chronic venous insufficiency questionnaire(CIVIQ)score,abnormal venous vein severity score(AVVSS)score,venous blood flow velocity of the affected limb and incidence of complications were recorded respectively before and 5 days after the treatment.Result Compared with that in the control group,the operation time and hospitalization time in the study group were much shorter(P<0.05),while the intraoperative blood loss and hospitalization expenses in the study group were remarkably less(P<0.05).After the treatment,the CIVIQ scores increased and the AVVSS decreased in both groups(P<0.05).Compared with that of the control group,the CIVIQ score of the study group was significantly higher(P<0.05),and the AVVSS much lower(P<0.05).After the treatment,the blood flow velocities of popliteal vein,femoral vein and external iliac vein in both groups were higher than those before the treatment(P<0.05),and the blood flow velocities was significantly higher in the study group than in the control group(P<0.05).The complication rate in the study group was 8.00%,which was much lower than that(24.00%)in the control group(P<0.05).Conclusions Compared with EVLA in the treatment of varicose great saphenous vein,the minimally invasive treatment of VeinHavst will effectively shorten the operation time,reduce intraoperative bleeding,relieve symptoms,improve venous function,speed up the blood flow of the affected limb,reduce complications and promote recovery.