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腔内激光治疗大隐静脉曲张的疗效评价 被引量:44

Endovascular laser for the treatment of great saphenous varicosity
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摘要 目的评价腔内激光治疗大隐静脉曲张 (ELVT)的近期疗效。方法 2 1例大隐静脉曲张患者 ,共 2 7条肢体 ,采用激光治疗结合大隐静脉高位结扎联合激光治疗及激光治疗同时行曲张团块及交通支切除 ,其中 1例的 1条肢体在大隐静脉高位结扎后将其近端的 2 0cm大隐静脉主干行激光治疗 15min后切除 ,标本送病理检查。结果 2 0例患者术后随访 2~ 6个月 ,彩色超声多普勒检查显示大隐静脉主干均发生血栓性闭塞。所有病例在术后 3~ 4周内均出现沿大隐静脉走行区域的皮肤青肿及皮下瘀斑。行病理学检查的一例大隐静脉壁穿破 ,静脉腔内血栓形成。结论腔内激光治疗下肢静脉曲张近期 (6个月以内 )疗效明确 ,损伤小 ,术后恢复快。其作用机制可能是激光引起静脉壁的热损伤 ,继发血栓形成 ,造成静脉主干闭塞。 Objective To evaluate the short term results of endovascular laser for the treatment (ELVT) of great saphenous varicosity. Methods Twenty one cases (a total of 27 lower extremities) were enrolled. Treatment included EL combined with ligation and resection of communicating branches. One patient underwent high ligation and resection of the great saphenous vein for the purpose of pathology after ELVT treatment. Result Twenty patients were followed-up for a period of 2~6 months. Color Duplex ultrosonography was conducted 2 weeks,4 weeks,and 6 mos,respectively. Thrombotic obliteration was found in all cases. Pathology study showed perforation of the vein with intimal injury and thrombosis. Conclusion The short term efficacy of EL treatment is definite with insignificant side-effect,and quick patient recovery. The mechanism is related to direct thermal injury of laser to the venous intima resulting in thrombotic obliteration.
出处 《中华普通外科杂志》 CSCD 北大核心 2004年第7期423-425,共3页 Chinese Journal of General Surgery
关键词 腔内激光治疗 大隐静脉曲张 大隐静脉高位结扎 病理检查 Varicose veins Thrombosis Endovenous laser
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参考文献5

  • 1Weiss RA. Comparison of endovenons radiofrequency versus 810nm diode laser occlusion of large veins in an animal model. Dermatol Surg, 2002, 28:59-61.
  • 2Proebstle TM, Lehr HA, Kargl A, et al. Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: Thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles. J Vasc Surg, 2002, 35:729-736.
  • 3Proebstle TM, Sandhofer M, Kargl A, et al. Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood. Dermatol Surg, 2002, 28:598-600.
  • 4Proebstle TM,Gül D, Lehr HA, et al. Infrequent early recanalization of greater saphenous vein after endovenous laser trentment. J Vasc Surg, 2003, 38:511-516.
  • 5Navarro L, Min RJ, Bone C. Endovenous laser: a new minimally invasive method of treatment for varicose veins-preliminary observations using and 810 nm diode laser. Dermatol Surg, 2001, 27:117-122.

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