Clinical effecacy of radiofrequency ablation combined with foam sclerotherapy and punctate stripping in treatment of great saphenous varicose veins#br#
FENG Weijing LI Jianming ZHOU Xuetao▲ ZEGN Wei CHEN Chen
Department of Surgery, Beijing Second Hospital, Beijing 100031, China
Abstract：Objective To explore the clinical efficacy of radiofrequency ablation combined with foam sclerotherapy and punctate stripping on treatment of great varicose veins. Methods A total of 80 patients with great saphenous varicose veins treated with Department of Surgery, Beijing Second Hospital from January 2014 to June 2020 were selected. A total of 38 patients treated with radiofrequency ablation combined with foam sclerotherapy and punctate stripping were as the observation group; 42 patients treated with high ligation and stripping of great saphenous veins were as the control group. Intraoperative blood loss, operation time, postoperative hospital length of stay, visual analogue scale (VAS) score, postoperative complications and venous clinical severity score (VCSS) were compared in two groups respectively. Results The amount of intraoperative blood loss in the observation group was less than that in the control group, the operation time and postoperative hospital stay were shorter than that in the control group, and the 24 h postoperative VAS score was lower than that in the control group (P ＜ 0.05). The incidence of subcutaneous ecchymosis and saphenous nerve injury in the observation group was lower than that in the control group (P ＜ 0.05). There was no significant difference in the incidence of incision infection between the two groups (P ＞ 0.05). No superficial thrombophlebitis and deep vein thrombosis occurred in the two groups. After one year follow-up, there was no recurrence in both groups. VCSS scores of the two groups one year after surgery were lower than those before surgery (P ＜ 0.05). Conclusion Radiofrequency ablation combined with foam sclerotherapy and punctate stripping have a significant effect in the treatment of great saphenous varicose veins, which can reduce intraoperative blood loss, shorten operation time and hospital length of stay, reduce complications, and facilitate rapid postoperative recovery.
[1] 陈涛，杨镛，杨国凯，等.大隐静脉曲张的微创治疗进展[J].中国微创外科杂志，2016，16（9）：841-844.
[2] 王云鹏，姚野，张博，等.射频消融术治疗下肢静脉曲张[J].内蒙古医科大学学报，2019，41（6）：670-672.
[3] 陈俞宏，李孝成，张炜.射频消融联合硬化剂注射治疗大隐静脉曲张的临床研究[J].山西医药杂志，2017，46（22）：2754-2756.
[4] Nicolaides AN，Allegra C，Bergan J，et al. Management of chronic venous disorders of the lower limbs：guidelines according to scientific evidence [J]. Int Angiol，2008，27：1-59.
[5] Vasquez MA，Rabe E，Lafferty RB，et al. Revision of the venous clinical severity score：venous outcomes consensus statement：special communication of the American Venous Forum Ad Hoc Outcomes Working Group [J]. J Vasc Surg，2010，52（5）：1387-1396.
[6] 下肢浅静脉曲张诊治共识微循环专家组.下肢浅静脉曲张诊治微循环专家共识[J].中华老年多器官疾病杂志，2020，19（1）：1-6.
[7] 宋均飞，殷世武.大隐静脉曲张微创治疗进展[J].安徽医药，2019，23（3）：437-440.
[8] Lawaetz M，Serup J，Lawaelz B，et al. Comparison of endovenous radio- frequency ablation laser ablation，foam sclerotherapy and surgical stripping for great -saphenous varicose veins.Extended 5-year follow-up of a RCT [J]. Int Angiol，2017，36（3）：281. DOI：10.23736/S0392-9590. 17.03827-5.
[9] 时明涛.3种方法治疗下肢静脉曲张的临床效果比较[J].中国现代普通外科进展，2020，23（2）：137-139.
[10] 牟彬，赵罡，孙闯，等.射频消融治疗大隐静脉曲张的近期有效性及安全性[J].中国介入影像与治疗学，2020， 17（2）：84-88.
[11] Tolva VS，Cireni LV，Bianchi PG，et al. Radiofrequency ablation of the great saphenous vein with the ClosureFAST procedure：mid-term experience on 400 patients from a single Centre [J]. Surg Today，2013，43（7）：741-744．
[12] 陆黎，陆炯，夏成勇，等.大隐静脉射频消融术与大隐静脉高位结扎剥脱术治疗静脉曲张的疗效对比[J].局部解剖学杂志，2020，29（1）：38-42.
[13] 邵长刚，王斌，迟国庆，等.大隐静脉射频消融术疗效分析[J].中国医刊，2019，54（8）：887-890.
[14] 庞凤舜，黄烈城，蔡北源，等.微创与传统治疗下肢静脉曲张的效果比较[J].中国医药导报，2018，15（26）：103-105，112.
[15] 刘洋，彭智猷，叶开创，等.静脉内射频消融术与激光消融术治疗大隐静脉曲张的比较[J].中国血管外科杂志：电子版，2021，13（1）：42-45，63.
[16] 苑超，高荣建，孙伟东，等.超声引导下腔内射频消融联合点式剥脱治疗下肢静脉曲张的临床效果观察[J].现代生物医学进展，2020，20（7）：1272-1276.
[17] 汪佳旭，张巍，韩天，等.超声引导射频消融治疗下肢静脉功能不全的疗效及预后影响因素分析[J].临床超声医学杂志，2021，23（5）：342-346.
[18] 肖应泽，张升宁.下肢浅静脉曲张微创治疗进展[J].中国中西医结合外科杂志，2017，23（3）：327-330.
[19] 徐涛，朱忆萍，谢懿漫，等.门诊泡沫硬化剂治疗老年下肢静脉曲张的安全性及疗效[J].中国老年学杂志，2021， 41（6）：1218-1220.
[20] 杨平印，姚群立.下肢浅静脉曲张的腔内治疗进展[J].医学综述，2018，24（17）：3414-3418.
[21] 黄毅，李梦帆，黄荣，等.大隐静脉高位结扎联合腔内激光闭合术和泡沫硬化剂注射治疗下肢静脉曲张的对比分析[J].临床外科杂志，2018，26（11）：814-817.
[22] 徐登，马伟，武建英.大隐静脉曲张手术治疗进展[J].中西医结合心血管病电子杂志，2020，8（5）：76-77.
[23] 张志轩，沈利明，金一琦，等.两种不同术式治疗大隐静脉曲张的临床疗效观察[J].中国血管外科杂志：电子版，2019，11（3）：219-220.
[24] 刘万里，宋燕，苗仁英，等.老年下肢静脉曲张患者两种联合微创手术方式对比分析[J].医药论坛杂志，2020， 41（11）：9-12，17.
[25] 郑明非，高继东，冯喆.腔内射频消融联合泡沫硬化剂治疗下肢静脉曲张的临床效果分析[J].医药论坛杂志，2020，41（11）：34-37.
[26] 苏苗苗，吴继东.腔内射频消融术治疗大隐静脉曲张患者的临床疗效[J].血管与腔内血管外科杂志，2020，6（4）：362-366.
京公网安备 11010502046598号