泡沫硬化剂联合高位结扎术与射频闭合联合高位结扎术治疗大隐静脉曲张疗效对比分析
|
摘要
目的探讨泡沫硬化剂联合高位结扎术与射频闭合联合高位结扎术治疗大隐静脉曲张的临床疗效。方法选择丽水市中心医院2016年3月—2017年3月血管外科收治的大隐静脉曲张患者80例为研究对象,按照随机数表法将其分为A、B组,A组采用泡沫硬化剂联合高位结扎术治疗,B组采用射频闭合术联合高位结扎术治疗。对比两组患者术中术后相关指标、临床疗效及术后生活质量,同时记录两组患者治疗过程中的并发症发生情况。结果两组患者术后下床活动时间及住院时间比较,差异无统计学意义(P>0.05);A组手术时间短于B组,B组术中出血量少于A组,差异均具有统计学意义(P<0.05)。A组临床有效率为95.00%,B组临床有效率为97.50%,两组临床疗效比较差异无统计学意义(P>0.05)。两组患者生理功能、情感职能、精神健康及社会功能维度比较,差异无统计学意义(P>0.05);A组患者躯体疼痛得分低于B组,差异具有统计学意义(P<0.05)。A组并发症发生率明显高于B组(35.50%vs 12.50%),差异具有统计学意义(P<0.05)。结论两种手术方式均疗效确切,但均存在一定的局限性,临床需要根据患者实际情况及患者意愿妥善选择手术治疗方式。
Objective To investigate the efficacy of foam sclerotherapy combined with high ligation and radiofrequency closure combined with high ligation in treatment of varicose veins of great saphenous vein. Methods 80 patients with varicose veins of great saphenous vein admitted in Lishui Central Hospital from March 2016 to March 2017 were selected as the subjects.They were divided into group A and group B according to the random number table method. The cases in the Group A were treated with foam sclerotherapy combined with high ligation. The cases in the group B were treated with radiofrequency closure combined with high ligation. Intraoperative and postoperative related indicators, clinical efficacy, quality of life and complications were compared between the two groups. Results There was no significant difference in the time of ambulation and hospitalization between the two groups(P>0.05). The time of operation in group A was shorter than that in group B, and the amount of bleeding in group B was less than that in group A, and the differences were statistically significant(P<0.05). The clinical effective rate in group A and group B was 95.00% and 97.50%, respectively. And there was no significant difference in the clinical effective rate between the two groups(P>0.05). There was no significant difference in the physiological function, emotional function, mental health and social function. The score of somatic pain in group A was lower than that in group B(P<0.05). The incidence of complications in group A was significantly higher than that in group B(35.50% vs 12.50%), and the difference was statistically significant(P<0.05). Conclusion Both methods have definite curative effect, but there are some limitations. It is necessary to choose the appropriate surgical treatment according to the actual situation of patients and patients' wishes.
Objective To investigate the efficacy of foam sclerotherapy combined with high ligation and radiofrequency closure combined with high ligation in treatment of varicose veins of great saphenous vein. Methods 80 patients with varicose veins of great saphenous vein admitted in Lishui Central Hospital from March 2016 to March 2017 were selected as the subjects.They were divided into group A and group B according to the random number table method. The cases in the Group A were treated with foam sclerotherapy combined with high ligation. The cases in the group B were treated with radiofrequency closure combined with high ligation. Intraoperative and postoperative related indicators, clinical efficacy, quality of life and complications were compared between the two groups. Results There was no significant difference in the time of ambulation and hospitalization between the two groups(P>0.05). The time of operation in group A was shorter than that in group B, and the amount of bleeding in group B was less than that in group A, and the differences were statistically significant(P<0.05). The clinical effective rate in group A and group B was 95.00% and 97.50%, respectively. And there was no significant difference in the clinical effective rate between the two groups(P>0.05). There was no significant difference in the physiological function, emotional function, mental health and social function. The score of somatic pain in group A was lower than that in group B(P<0.05). The incidence of complications in group A was significantly higher than that in group B(35.50% vs 12.50%), and the difference was statistically significant(P<0.05). Conclusion Both methods have definite curative effect, but there are some limitations. It is necessary to choose the appropriate surgical treatment according to the actual situation of patients and patients' wishes.
引文
[1]周梅峰,宋菊民.聚多卡醇泡沫硬化剂联合大隐静脉高位结扎治疗大隐静脉曲张的疗效观察[J].贵州医药,2018,42(1):73-74.
[2]WANG X,MENG J,ZHANG J,et al.Curative effects of RFcombined with DSA-guided ethanol sclerotherapy in venous malformations[J].Exp Ther Med,2016,12(6):3670-3674.
[3]周梅峰,宋菊民.聚多卡醇泡沫硬化剂联合大隐静脉高位结扎治疗大隐静脉曲张的疗效观察[J].贵州医药,2018,42(1):73-74.
[4]陆民浩,杨静,赵滨.泡沫硬化剂联合大隐静脉高位结扎术治疗下肢静脉曲张的研究[J].临床和实验医学杂志,2015,13(2):149-151.
[5]美国静脉论坛CEAP分级国际特别委员会.共识报告--慢性静脉病变CEAP分级法的修订[J].中华外科杂志,2006,44(1):59-61.
[6]周智勇.高位结扎联合泡沫硬化剂治疗大隐静脉曲张的临床分析[J].世界中医药,2015,10(1):657-658.
[7]张磊,徐德忠,黄久仪,等.SF-36量表中文版的应用及分级截断点选择的研究[J].中华流行病学杂志,2004,25(1):69-73.
[8]王雪钢,白斗,武少辉,等.高位结扎联合泡沫硬化剂注射治疗大隐静脉曲张临床观察[J].实用医院临床杂志,2015,12(2):103-104.
[9]赵淑玲.大隐静脉高位结扎联合泡沫硬化剂注射治疗下肢静脉曲张的综合护理效果分析[J].河北医学,2018,24(5):165-168.
[10]孙波,孙静,曹广信,等.高位结扎剥脱大隐静脉主干联合泡沫剂硬化属支治疗下肢静脉曲张的疗效与经济价值分析[J].实用医院临床杂志,2016,13(2):82-84.
[11]艾杨卿,李志军.大隐静脉高位结扎联合硬化剂注射治疗下肢静脉曲张的临床应用价值[J].心肺血管病杂志,2018,37(2):137-139.
[12]SADICK N S.Advances in the treatment of varicose veins:ambulatory phlebectomy,foam sclerotherapy,endovascular laser,and radiofrequency closure[J].Adv Dermatol,2016,22:139-156.
[13]徐清华,查俊华,吴醒,等.泡沫硬化剂联合腔内激光闭合术治疗下肢静脉曲张的疗效[J].江苏医药,2017,43(21):1539-1541.
[14]黄渌,张婉,崔佳森,等.传统手术联合泡沫硬化剂注射术在老年下肢静脉曲张治疗中的应用现状[J].老年医学与保健,2016,22(5):323-325.
[15]朱俊,宋承鹏,李栋梁,等.腔内激光闭合术联合高位结扎术治疗原发性大隐静脉功能不全的并发症防治研究[J].中国临床保健杂志,2017,20(1):94-95.
[16]肖帆,魏刚.腔内射频消融术治疗单纯性大隐静脉曲张的手术护理[J].检验医学与临床,2014,14(6):860-860.
[17]闫文锋,吴刚,许延发.激光腔内闭合术联合高位结扎术治疗大隐静脉曲张疗效观察[J].中华实用诊断与治疗杂志,2015,29(8):786-787.
[18]陈诚,庄晖,戴贻权,等.射频消融联合泡沫硬化剂注射术治疗下肢静脉曲张的临床疗效观察[J].血管与腔内血管外科杂志,2017,3(6):625-626.
[2]WANG X,MENG J,ZHANG J,et al.Curative effects of RFcombined with DSA-guided ethanol sclerotherapy in venous malformations[J].Exp Ther Med,2016,12(6):3670-3674.
[3]周梅峰,宋菊民.聚多卡醇泡沫硬化剂联合大隐静脉高位结扎治疗大隐静脉曲张的疗效观察[J].贵州医药,2018,42(1):73-74.
[4]陆民浩,杨静,赵滨.泡沫硬化剂联合大隐静脉高位结扎术治疗下肢静脉曲张的研究[J].临床和实验医学杂志,2015,13(2):149-151.
[5]美国静脉论坛CEAP分级国际特别委员会.共识报告--慢性静脉病变CEAP分级法的修订[J].中华外科杂志,2006,44(1):59-61.
[6]周智勇.高位结扎联合泡沫硬化剂治疗大隐静脉曲张的临床分析[J].世界中医药,2015,10(1):657-658.
[7]张磊,徐德忠,黄久仪,等.SF-36量表中文版的应用及分级截断点选择的研究[J].中华流行病学杂志,2004,25(1):69-73.
[8]王雪钢,白斗,武少辉,等.高位结扎联合泡沫硬化剂注射治疗大隐静脉曲张临床观察[J].实用医院临床杂志,2015,12(2):103-104.
[9]赵淑玲.大隐静脉高位结扎联合泡沫硬化剂注射治疗下肢静脉曲张的综合护理效果分析[J].河北医学,2018,24(5):165-168.
[10]孙波,孙静,曹广信,等.高位结扎剥脱大隐静脉主干联合泡沫剂硬化属支治疗下肢静脉曲张的疗效与经济价值分析[J].实用医院临床杂志,2016,13(2):82-84.
[11]艾杨卿,李志军.大隐静脉高位结扎联合硬化剂注射治疗下肢静脉曲张的临床应用价值[J].心肺血管病杂志,2018,37(2):137-139.
[12]SADICK N S.Advances in the treatment of varicose veins:ambulatory phlebectomy,foam sclerotherapy,endovascular laser,and radiofrequency closure[J].Adv Dermatol,2016,22:139-156.
[13]徐清华,查俊华,吴醒,等.泡沫硬化剂联合腔内激光闭合术治疗下肢静脉曲张的疗效[J].江苏医药,2017,43(21):1539-1541.
[14]黄渌,张婉,崔佳森,等.传统手术联合泡沫硬化剂注射术在老年下肢静脉曲张治疗中的应用现状[J].老年医学与保健,2016,22(5):323-325.
[15]朱俊,宋承鹏,李栋梁,等.腔内激光闭合术联合高位结扎术治疗原发性大隐静脉功能不全的并发症防治研究[J].中国临床保健杂志,2017,20(1):94-95.
[16]肖帆,魏刚.腔内射频消融术治疗单纯性大隐静脉曲张的手术护理[J].检验医学与临床,2014,14(6):860-860.
[17]闫文锋,吴刚,许延发.激光腔内闭合术联合高位结扎术治疗大隐静脉曲张疗效观察[J].中华实用诊断与治疗杂志,2015,29(8):786-787.
[18]陈诚,庄晖,戴贻权,等.射频消融联合泡沫硬化剂注射术治疗下肢静脉曲张的临床疗效观察[J].血管与腔内血管外科杂志,2017,3(6):625-626.