摘要
目的探讨血管腔内微波消融(EMA)与射频消融(RFA)闭合大隐静脉主干的疗效和安全性差异。方法收集2019年1—6月浙江省人民医院收治的316例大隐静脉功能不全患者的临床资料,并按照性别、年龄、病程、体重指数、身高、基础临床表现-病因-解剖-病理生理(CEAP)分级、大隐静脉主干直径的不同将患者筛选并分层配对为EMA组(n=157)和RFA组(n=159)。采用视觉模拟评分法(VAS)评价两组患者术后14 d的大隐静脉主干闭合段疼痛情况和皮肤瘀伤情况;术后第14天、6个月,所有患者均通过超声复查治疗段大隐静脉主干闭合情况。比较两组患者的术后并发症发生情况。结果RFA组患者的术后VAS最高评分出现在术后第1天,EMA组患者的术后VAS最高评分出现在术后第3天。术后第1~10天,两组患者的VAS评分存在差异;与EMA组患者相比,RFA组患者的术后VAS评分更低。两组患者的皮肤瘀伤最高评分均出现在术后第4天;与EMA组患者相比,RFA组患者的皮肤瘀伤评分较低;术后第5~9天,两组患者的皮肤瘀伤评分差异较大。两组患者术后第14天、6个月的治疗段大隐静脉主干闭合率、术后并发症发生情况比较,差异均无统计学意义(P>0.05)。结论与行EMA闭合术治疗的患者相比,行RFA闭合术治疗的患者围手术期疼痛和皮肤瘀伤的发生率相对较低,但EMA和RFA均能够有效治疗大隐静脉功能不全,短期疗效肯定,长期疗效仍需随访。
Objective To compare the efficacy and safety of endovascular microwave ablation(EMA)and endovascular radio frequency ablation(RFA)in the closure of the trunk of great saphenous vein(GSV).Method Clinical data of 316 patients with GSV insufficiency treated in Zhejiang Provincial Peoples'Hospital From January 2019 to June 2019 were collected.The patients were selected and matched into EMA group(n=157)and RFA group(n=159)according to gender,age,course of disease,body mass index,height,basic clinical etiology anatomy pathophysiology(CEAP)classification and diameter of the trunk of GSV.Visual analogue scale(VAS)was used to evaluate the pain and skin bruise of the closed segment of the trunk of GSV 14 days after operation.On the 14th day and 6 months after operation,all patients reviewed the closure of the trunk of GSV in the treatment section by ultrasound.The postoperative complications of the two groups were compared.Result The highest postoperative VAS score of patients in RFA group appeared on the first day after operation,and the highest postoperative VAS score of patients in EMA group appeared on the third day after operation.There were differences in VAS scores between the two groups from 1 to 10 days after operation.Compared with patients in EMA group,patients in RFA group had lower postoperative VAS score.The highest score of skin bruising in both groups appeared on the 4th day after operation;compared with patients in EMA group,patients in RFA group had lower skin bruise score.There were significant differences in skin bruise scores between the two groups on the 5th to 9th day after operation.There was no significant difference in the closure rate of the main saphenous vein of the treatment section and the incidence of postoperative complications between the two groups on the 14th day and 6 months after operation(P>0.05).Conclusion Compared with patients treated with EMA closure,patients treated with RFA closure have relatively less perioperative pain and skin bruises,but both EMA and RFA can effectively treat great saphenous vein insufficiency.The short-term effect is positive,and the long-term effect still needs to be followed up.
作者
卢凯平
卢惟钦
杨光唯
来集富
蒋劲松
Lu Kaiping;Lu Weiqin;Yang Guangwei;Lai Jifu;Jiang Jinsong(Department of Vascular Surgery,Zhejiang Provincial Peoples'Hospital,Hangzhou 310014,Zhejiang,China)
出处
《血管与腔内血管外科杂志》
2022年第1期22-26,共5页
Journal of Vascular and Endovascular Surgery
基金
浙江省教育厅一般科研项目(Y202044641)。
关键词
微波消融
射频消融
大隐静脉功能不全
疗效
安全性
microwave ablation
radio frequency ablation
great saphenous vein insufficiency
curative effect
security
