摘要
目的探讨腔内激光闭合联合泡沫硬化剂治疗下肢静脉曲张的疗效及对肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)的影响。方法选择120例下肢静脉曲张手术的患者,分为对照组和观察组,各60例,对照组患者使用大隐静脉行高位结扎术和剔剥术+术后加压治疗的方案,观察组患者使用腔内激光闭合+泡沫硬化剂+术后加压+口服药巩固治疗的方案,对比治疗效果,并且分析对TNF-α和IL-6的影响。结果观察组患者在平均手术时间、平均失血量、术后72 h视觉模拟评分法(VAS)评分和平均住院时间均明显低于对照组,差异均有统计学意义(t分别=9.59、45.47、7.50、20.27,P均<0.05),对照组与观察组患者手术前、手术后1个月的静脉疾病临床严重程度评分(VCSS)评分、TNF-α、IL-6水平比较,差异均无统计学意义(t分别=0.54、0.36、1.24;0.30、0.59、0.60,P均>0.05),但在手术后6个月,观察组VCSS评分、TNF-α、IL-6水平均低于对照组,差异具有统计学意义(t分别=19.67、15.01、3.85,P均<0.05)。手术后6个月,观察组复发率明显低于对照组(χ~2=7.57,P<0.05)。结论利用腔内激光闭合联合泡沫硬化剂对下肢静脉曲张患者进行手术治疗后,联合物理加压和口服药物的方法,可以提升下肢静脉曲张患者的治疗效果,降低患者的远期复发率,改善TNF-α、IL-6的水平。
Objective To investigate the curative effect of endoscopic laser closure combined with foam sclerotherapy in the treatment of varicose veins of lower extremities and its influence on TNF-α and IL-6. Methods Totally 120 cases of patients with lower extremity varicose veins were divided into the control group and the observation group with sixty patients in each. The control group was given the treatment regimen consisting of large saphenous vein high ligation,decoction surgery,and postoperative pressure,the observation group was given the treatment regimen consisting of intracavity laser closed,foam hardener,postoperative pressure,and oral medication consolidation. The effects of treatment were compared and its influence on TNF-α and IL-6 was analyzed. Results The average operation time,average blood loss,postoperative VAS score of 72 hrs and the average hospitalization time of the observation group were significantly lower than the control group（t=9.59,45.47,7.50,20.27,P〈0.05）. The differences in VCSS score,TNF-α,and IL-6 levels between two groups before surgery and 1 month after surgery were not statistically significant（t=0.54,0.36,1.24;0.30,0.59,0.60,P〉0.05）. At 6 months after surgery,the VCSS score,TNF-α,and IL-6 levels of the observation group were significantly lower than those of the control group（t=19.67,15.01,3.85,P〈0.05） as well as the recurrence rate（χ^2=7.57,P〈0.05）. Conclusion After treating with intracavity laser closure combined with foam hardening agent for patients with lower extremity varicose veins,the physical compression combined with oral drug can improve the treatment of patients with varicose veins,reduce the long-term recurrence of patients,and improve TNF-αand IL-6 levels.
作者
詹杰锋
周伟可
ZHAN Jiefeng ZHOU Weike(Department of Surgery,The Fourth People＇ s Hospital of Zhuji,Zhuji 311835, China.)
出处
《全科医学临床与教育》
2017年第4期391-394,共4页
Clinical Education of General Practice
关键词
激光
泡沫硬化剂
下肢静脉曲张
laser
foam hardener
lower extremity varicose veins
