Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation（EVLA） is a frequently used method. A newly developed alternative, based on thermal th...Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation（EVLA） is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation（EMA）. This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA（EMA group）, and the rest 6 with EVLA（EVLA group）. Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points： before, immediately after, 24 h（and 48 h） after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month（s） after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats.展开更多
目的探讨大隐静脉曲张腔内微波消融术时,大隐静脉主干高位结扎和不结扎对疗效的影响。方法采用前瞻性随机对照研究,2018年3月至2019年1月,按照纳入和排除标准共纳入236例单侧下肢浅静脉曲张患者,按照随机数字表法分为观察组(122例)和对...目的探讨大隐静脉曲张腔内微波消融术时,大隐静脉主干高位结扎和不结扎对疗效的影响。方法采用前瞻性随机对照研究,2018年3月至2019年1月,按照纳入和排除标准共纳入236例单侧下肢浅静脉曲张患者,按照随机数字表法分为观察组(122例)和对照组(114例)。观察组采用大隐静脉主干单纯腔内微波消融闭合术,未高位结扎大隐静脉主干;对照组采用大隐静脉主干腔内微波消融闭合术联合大隐静脉主干高位结扎治疗。比较两组手术时间、住院时间、疼痛程度、误伤深静脉发生率、大隐静脉残端血栓形成率、大隐静脉主干再通率、静脉曲张复发率等。结果观察组的手术时间[(42.27±3.79)min比(53.45±5.33)min,t=18.46,P<0.01]、住院时间[(2.29±0.55)d比(2.65±0.72)d,t=4.37,P<0.01]均短于对照组,差异有统计学意义。观察组术后疼痛程度低于对照组(χ^(2)=84.96,P<0.01)。术后2周,观察组大隐静脉残端血栓形成率高于对照组,差异有统计学意义(11/122比2/114,χ^(2)=5.97,P=0.02)。大隐静脉残端血栓形成病例中,观察组中大隐静脉主干直径>8 mm 7例,≤8 mm 4例,对照组大隐静脉主干直径>8 mm和≤8 mm各1例。术后12个月,观察组与对照组在大隐静脉主干再通率、静脉曲张复发情况方面,差异均无统计学意义(P均>0.05)。结论大隐静脉曲张腔内微波消融术联合或不联合高位结扎大隐静脉主干都可改善了下肢浅静脉曲张的严重程度。但微波消融术大隐静脉主干未高位结扎,明显缩短手术时间和住院时间,并降低术后疼痛。展开更多
目的探讨腔内微波闭合术(EMA)治疗大隐静脉曲张的临床疗效。方法选取2018年1月-2019年1月天津市第一中心医院收治的197例(231条肢体)大隐静脉曲张患者为研究对象,随机分为对照组100例和观察组97例。对照组采取大隐静脉高位结扎剥脱术,...目的探讨腔内微波闭合术(EMA)治疗大隐静脉曲张的临床疗效。方法选取2018年1月-2019年1月天津市第一中心医院收治的197例(231条肢体)大隐静脉曲张患者为研究对象,随机分为对照组100例和观察组97例。对照组采取大隐静脉高位结扎剥脱术,观察组采取EMA。比较分析两组患者手术时间、术中失血量、术后住院时间、术后48 h VAS评分、术后并发症发生率及术前、术后的VCSS评分、AVVQ评分情况。结果观察组手术时间、术中失血量、术后住院时间及术后48 hVAS疼痛评分均优于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率为9.3%,明显低于对照组的28.0%,差异有统计学意义(P<0.05)。两组术后1年VCSS评分明显低于手术前,差异均有统计学意义(P<0.05)。术后3个月,观察组AVVQ评分低于对照组,差异有统计学意义(P<0.05)。结论EMA是治疗大隐静脉曲张的有效方法,值得临床推广应用。展开更多
基金supported by grants from Shanghai Science and Technology Commission(No.13401903900)Municipal Health Bureau of Traditional Chinese Medicine Development Office(No.ZYSNXD-YL-YSZK010 and No.ZXb Z2012-09)Appropriate Technology Project of Shanghai Shenkang Hospital Development Center(No.SHDC12014242)
文摘Increasing number of endovenous techniques are available for the treatment of saphenous vein reflux and endovenous laser ablation（EVLA） is a frequently used method. A newly developed alternative, based on thermal therapy, is endovenous microwave ablation（EMA）. This study evaluated the effect of the two procedures, in terms of coagulation and histological changes, in occluding lateral veins in goats. Twelve animals were randomized into two group, with 6 treated with EMA（EMA group）, and the rest 6 with EVLA（EVLA group）. Results of coagulation, including coagulation, fibrinolysis and platelet activation, were assessed at three or four different time points： before, immediately after, 24 h（and 48 h） after ablation. The diameter change, a measure of efficacy, was ultrasonographically measured before and 1 month after the ablation. Histological changes were grossly and microscopically evaluated immediately, 1 and 3 month（s） after the ablation. The length of the ablated vein and preoperative average diameter were comparable between the two groups. In both EMA and EVLA groups, several coagulation parameters, fibrinolysis and platelet activation parameters only underwent slight changes. Ultrasound imaging displayed that the diameter reduction of the veins treated by EMA was significantly larger than by EVLA, in consistent with the results of macroscopic examination. Microscopic examination revealed necrosis and thickening of the vein wall, and occlusion of the lumen within 3 months after ablation in both EMA and EVLA groups. It is concluded that EMA is a minimally invasive therapy, which appears to be safe and effective for treatment of lateral veins in goats.
文摘目的探讨大隐静脉曲张腔内微波消融术时,大隐静脉主干高位结扎和不结扎对疗效的影响。方法采用前瞻性随机对照研究,2018年3月至2019年1月,按照纳入和排除标准共纳入236例单侧下肢浅静脉曲张患者,按照随机数字表法分为观察组(122例)和对照组(114例)。观察组采用大隐静脉主干单纯腔内微波消融闭合术,未高位结扎大隐静脉主干;对照组采用大隐静脉主干腔内微波消融闭合术联合大隐静脉主干高位结扎治疗。比较两组手术时间、住院时间、疼痛程度、误伤深静脉发生率、大隐静脉残端血栓形成率、大隐静脉主干再通率、静脉曲张复发率等。结果观察组的手术时间[(42.27±3.79)min比(53.45±5.33)min,t=18.46,P<0.01]、住院时间[(2.29±0.55)d比(2.65±0.72)d,t=4.37,P<0.01]均短于对照组,差异有统计学意义。观察组术后疼痛程度低于对照组(χ^(2)=84.96,P<0.01)。术后2周,观察组大隐静脉残端血栓形成率高于对照组,差异有统计学意义(11/122比2/114,χ^(2)=5.97,P=0.02)。大隐静脉残端血栓形成病例中,观察组中大隐静脉主干直径>8 mm 7例,≤8 mm 4例,对照组大隐静脉主干直径>8 mm和≤8 mm各1例。术后12个月,观察组与对照组在大隐静脉主干再通率、静脉曲张复发情况方面,差异均无统计学意义(P均>0.05)。结论大隐静脉曲张腔内微波消融术联合或不联合高位结扎大隐静脉主干都可改善了下肢浅静脉曲张的严重程度。但微波消融术大隐静脉主干未高位结扎,明显缩短手术时间和住院时间,并降低术后疼痛。
文摘目的探讨腔内微波闭合术(EMA)治疗大隐静脉曲张的临床疗效。方法选取2018年1月-2019年1月天津市第一中心医院收治的197例(231条肢体)大隐静脉曲张患者为研究对象,随机分为对照组100例和观察组97例。对照组采取大隐静脉高位结扎剥脱术,观察组采取EMA。比较分析两组患者手术时间、术中失血量、术后住院时间、术后48 h VAS评分、术后并发症发生率及术前、术后的VCSS评分、AVVQ评分情况。结果观察组手术时间、术中失血量、术后住院时间及术后48 hVAS疼痛评分均优于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率为9.3%,明显低于对照组的28.0%,差异有统计学意义(P<0.05)。两组术后1年VCSS评分明显低于手术前,差异均有统计学意义(P<0.05)。术后3个月,观察组AVVQ评分低于对照组,差异有统计学意义(P<0.05)。结论EMA是治疗大隐静脉曲张的有效方法,值得临床推广应用。
