电凝术治疗下肢静脉曲张并发症的预防及处理

详细信息    查看全文 | 推荐本文 |

英文篇名：Prevention and treatment of complications of lower extremity varicose veins treated by electrocoagulation 作者：刚清伟 ; 王成刚 ; 吴丹明 ; 贾琪 ; 张立魁 ; 沈世凯 英文作者：GANG Qing-wei;WANG Cheng-gang;WU Dan-ming;JIA Qi;ZHANG Li-kui;SHEN Shi-kai;Department of Vascular and Hernia Surgery, The People's Hospital of Liaoning Province; 关键词：静脉曲张 ; 微创 ; 电凝术 英文关键词：Varicose veins;;Minimally invasive;;Electrocoagulation 中文刊名：XGWK 英文刊名：Chinese Journal of Vascular Surgery(Electronic Version) 机构：辽宁省人民医院血管疝外科; 出版日期：2019-06-20 出版单位：中国血管外科杂志(电子版) 年：2019 期：v.11 语种：中文; 页：XGWK201902006 页数：4 CN：02 ISSN：11-9303/R 分类号：16-18+22

摘要

目的探讨电凝术治疗下肢静脉曲张相关并发症的预防及处理方法。方法回顾性分析辽宁省人民医院2000年11月至2017年12月收治的4509例(5376条患肢)采用电凝术治疗的下肢静脉曲张患者的临床资料。其中CEAP分类:C2级667条(12.41%),C3级3845条(71.52%),C4级716条(13.31%),C5级62条(1.15%),C6级86条(1.60%)。结果 5376条患肢均手术成功,平均手术时间(48.0±6.2)min,平均住院时间(5.6±1.3)d。术后随访6～60个月,出现早期并发症包括皮肤灼伤94条(1.75%)、皮下硬结116条(2.16%)、局部血肿164条(3.05%),出现中远期并发症包括小腿皮肤麻木274条(5.10%)、色素沉着133条(2.47%)、术后复发120条(2.23%),均予相应的对症治疗。结论合理地使用电凝术是有效的降低术后并发症的关键。
        Objective To analyze the prevention and treatment of complications caused by electrocoagulation in the treatment of varicose veins. Methods The clinical data of 4509 patients(5376 limbs) who were diagnosed with the varicose veins of lower extremity and treated with classical surgery assisted with electrocoagulation from 2000 to 2017 in the People's Hospital of Liaoning Province were retrospectively analyzed. CEAP classification: C2 667 cases(12.41%), C3 3845 cases(71.52%), C4 716 cases(13.31%), C5 62 cases(1.15%), C6 86 cases(1.60%). Results All of the 5376 limbs were cured.The average operation time was(48.0±6.2) minutes and the average hospital stay was(5.6±1.3) days. The patients were followed up for 6～60 months, 94 limbs(1.75%) developed skin burns, 116 limbs(2.16%)were subcutaneous induration, 164 limbs(1.60%) were hematoma at early stages;274 cases(5.10%)were skin numbness, 133 limbs(2.47%) were pigmentation, and 120 limbs(2.23%) were recurrence In the medium and long term. Conclusion Using electrocoagulation correctly can reduce the incidence of complications effectively.

引文

[1]Mallick R,Raju A,Campbell C,et al.Treatment patterns and outcomes in patients with varicose veins[J].Am Health Drug Benefits,2016,9(8):455-465.
    [2]De Maeseneer M,Biemans A,Pichot O.New concepts on recurrence of varicose veins according to the different treatment techniques[J].Phlébologie,2013,66(4):54-60.
    [3]王爱林,徐恒,徐福军,等.应用剥脱电凝方法治疗下肢静脉曲张性溃疡[J/CD].中国血管外科杂志(电子版),2013,5(2):123-124.
    [4]吴丹明,董齐,易巍,等.电凝术治疗下肢静脉曲张27例临床分析[J].中国实用外科杂志,2002,22(2):99-100.
    [5]王成刚,吴丹明,周玉斌,等.电凝术治疗下肢静脉曲张的评价[J].中国实用外科杂志,2006,26(6):450-452.
    [6]Lee DK,Ahn KS,Kang CH,et al.Ultrasonography of the lower extremity veins:anatomy and basic approach[J].Ultrasonography,2017,36(2):120-130.
    [7]贾琪,吴丹明,王成刚,等.点式勾除术联合电凝闭合术治疗下肢静脉曲张[J].中国美容整形外科杂志,2016,27(2):95-97.
    [8]赵海光,陆信武.血管美容新理念及发展趋势探讨[J/CD].中国血管外科杂志(电子版),2017,9(3):226-228.
    [9]Mahhou-Sennouni F,Robert-Ebadi H,Righini M,et al.Foam sclerotherapy to treat varicose veins[J].Rev Med Suisse,2016,12(542):2126-2130.
    [10]Ferreira A,Ramos J,Cerqueira A,et al.Radiofrequency-powered segmental thermal ablation in chronic venous disorders:A single center experience[J].Rev Port Cir Cardiotorac Vasc,2011,18(2):123-127.
    [11]Tyloch JF,Maria WM,Pawe? WA.Standards of the Polish Ultrasound Society-update.Ultrasound examination of the kidneys,ureters and urinary bladder[J].J Ultrason,2013,13(54):293-307.
    [12]Wo niak W,Mlosek RK,Ciostek P.Assessment of the efficacy and safety of steam vein sclerosis as compared to classic surgery in lower extremity varicose vein management[J].Wideochir Inne Tech Maloinwazyjne,2015,10(1):15-24.