高晶晶,
邵华^,,
王寒,
孙英伦,
辛明霞
大连大学附属新华医院 血管外科，辽宁 大连 116000

基金项目: 大连市医学科学研究计划项目（1911118）


详细信息 作者简介: 高晶晶（1997-），女，硕士研究生。E-mail：gjj971130@163.com





通讯作者: 邵 华，副教授。E-mail：174799575@qq.com 中图分类号: R654.3


摘要:目的观察超声引导下腔内射频消融术（RFA）联合泡沫硬化剂治疗单纯性下肢静脉曲张的临床疗效。方法选取2019年10月至2021年10月大连大学附属新华医院收治的229例单纯性大隐静脉曲张患者，按手术方式分为A组（RFA+泡沫硬化剂组）83例和B组（大隐静脉高位结扎剥脱+泡沫硬化剂组）146例，比较两组术中出血量，手术时间，住院总费用，住院时间，术后1、6、12个月的手术并发症（切口感染、血栓闭塞性浅静脉炎、瘀斑、色素沉着、感觉异常、疼痛）以及术前术后静脉临床严重程度评分（VCSS），术后复发率等。结果A组术中出血量（10.50±5.27） mL 少于B组 （18.80±5.67） mL，手术时间（60.50±21.36） min 短于B组 （69.00±25.55） min，住院时间（4.14±2.15） d 短于B组 （7.68±3.45） d，差异均有统计学意义（P＜0.05）。A组住院总费用（18150±1107.72）元多于B组（10200±1178.03）元，差异有统计学意义（P＜0.05）。术后12个月手术并发症发生率A组3.61%低于B组31.51%，差异有统计学意义（P＜0.05）。A组和B组术后均无复发。结论超声引导下RFA联合泡沫硬化剂相比大隐静脉高位结扎剥脱术联合泡沫硬化剂治疗单纯性下肢大隐静脉曲张的手术时间更短、创伤更小、恢复更快，具有良好的临床疗效。
关键词: 下肢静脉曲张/
射频消融术/
泡沫硬化剂


Abstract:ObjectiveTo study the clinical efficacy of ultrasound-guided endovenous radiofrequency ablation (RFA) combined with foam sclerosing agent in the treatment of simple lower extremity varicose veins.MethodsA total of 229 patients with simple great saphenous varicose veins were admitted to Xinhua Hospital affiliated to Dalian University from October 2019 to October 2021, and the patients were divided into group A (RFA + foam sclerotherapy group, n=83) and group B (high ligation and stripping of great saphenous vein + foam sclerotherapy group, n=146), comparing intraoperative blood loss, operation time, total hospitalization cost, length of hospital stay, surgical complications (incision infection, thrombophlebitis obliterans, ecchymosis, pigmentation, paresthesia, pain) and preoperative and postoperative venous clinical severity score (VCSS), postoperative recurrence rate, etc.ResultsThe blood loss [(10.50±5.27) mL vs (18.80±5.67) mL], operation time [(60.50±21.36) min vs (69.00±25.55) min] and hospitalization time [(4.14±2.15) d vs (7.68±3.45) d] in group A were less than those in group B. The differences were statistically significant (P＜0.05). The total cost of hospitalization in group A [(18150±1107.72) yuan] was more than that in group B [(10200±1178.03) yuan], and the difference was statistically significant (P＜0.05). The incidence of surgical complications in group A was lower than that in group B. There was no recurrence in group A and group B after operation.ConclusionUltrasound-guided intraluminal radiofrequency ablation combined with foam sclerotherapy has shorter operation time, less trauma and faster recovery than high ligation and stripping of the great saphenous vein combined with sclerotherapy in the treatment of simple varicose veins of the lower extremities. It has good clinical efficacy and has become the best surgical method for the treatment of simple great saphenous vein.
Keywords:varicose veins of the lower extremities/
radiofrequency ablation/
foam sclerotherapy

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