摘要
目的:对比分析静脉腔内激光(EVLT)与传统手术治疗对下肢静脉曲张的近期疗效。方法:回顾性分析114例下肢静脉曲张患者临床资料,其中EVLT治疗59例(EVLT组,97肢),传统大隐静脉高位结扎+剥脱术治疗55例(对照组,91肢)。记录两组患者临床疗效、手术相关指标、术后恢复情况及术后并发症发生情况,比较两组术前及术后3 d应激反应[C反应蛋白(CRP)、皮质醇(COR)]、术后8周及12周切口瘢痕状况[温哥华瘢痕量表(VSS)]、切口美容满意度[视觉模拟评分(VAS)]差异。结果:两组临床疗效及静脉炎、皮肤烧灼发生情况比较,差异无统计学意义(P>0.05)。EVLT组的手术时间、术中出血量、切口数量、切口长度、术后镇痛药物应用率、术后住院时间及术后皮下血肿、隐神经损伤发生率均低于对照组(P<0.05)。术后3 d,两组血清CRP、COR均较术前升高(P<0.05),且对照组高于EVLT组(P<0.05)。术后12周,两组切口瘢痕VSS评分低于术后8周(P<0.05),美容满意度VAS评分高于术后8周(P<0.05);且术后8周及12周时,EVLT组切口瘢痕VSS评分低于对照组(P<0.05),美容满意度VAS评分高于对照组(P<0.05)。结论:EVLT对下肢静脉曲张的近期疗效与传统手术相当,但EVLT治疗创伤小、并发症少,术后瘢痕状况好,应用价值更高。
Objective:To analyze and compare the short-term efficacy of endovenous laser treatment(EVLT)and traditional surgical treatment on varicose veins of lower extremities.Methods:The clinical data of 114 patients with varicose veins of lower extremities were retrospectively analyzed,including 59 cases of EVLT treatment(EVLT group,97 limbs)and 55 cases of traditional high ligation of great saphenous vein+stripping(control group,91 limbs).The clinical efficacy,surgery-related indicators,postoperative recovery and occurrence of postoperative complications were recorded in the two groups,and the stress responses[C reactive protein(CRP),cortisol(COR)]before surgery and at 3d after surgery and incision scar status[Vancouver Scar Scale(VSS)]and incision cosmetic satisfaction[Visual Analogue Scale(VAS)]at 8 and 12 weeks after surgery were compared between the two groups.Results:There were no significant differences in the clinical efficacy and occurrence of phlebitis and skin burning between the two groups(P>0.05).The surgical time,intraoperative blood loss,incision quantity,incision length,application rate of postoperative analgesic drugs,postoperative hospital stay,incidence rates of postoperative subcutaneous hematoma and saphenous nerve injury in EVLT group were all lower than those in control group(P<0.05).At 3 d after surgery,the levels of serum CRP and COR in the two groups were higher than those before surgery(P<0.05),and the levels in control group were higher than those in EVLT group(P<0.05).At 12 weeks after surgery,the incision scar VSS scores in the two groups were lower than those at 8 weeks after surgery(P<0.05),and the cosmetic satisfaction VAS scores were higher than those at 8 weeks after surgery(P<0.05).At 8 and 12 weeks after surgery,the incision scar VSS score in EVLT group was lower than that in control group(P<0.05),and the cosmetic satisfaction VAS score was higher than that in control group(P<0.05).Conclusion:Both EVLT and traditional surgery have good effects in the treatment of varicose veins of lower extremities,but EVLT has less trauma,fewer complications,better postoperative scar status and higher application value.
作者
赵超峰
高翔
ZHAO Chao-feng;GAO Xiang(Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,Bozhou 236800;Department of Surgery,the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230000,Anhui,China)
出处
《川北医学院学报》
CAS
2021年第8期1049-1052,共4页
Journal of North Sichuan Medical College
关键词
下肢静脉曲张
EVLT
传统大隐静脉高位结扎+剥脱术
微创
切口
瘢痕
Varicose veins of lower extremities
EVLT
Traditional high ligation of great saphenous vein+stripping
Minimally invasive
Incision
Scar
