摘要
目的探讨高龄患者下肢静脉曲张日间手术的安全性及可行性。方法收集2016年1月至2019年9月浙江大学医学院附属邵逸夫医院收治的186例行下肢静脉曲张射频消融日间手术高龄患者的临床资料,对所有患者均于术后3 d、1个月、3个月及1年进行随访,评估其手术成功率、手术时间、术中出血量及麻醉肿胀液使用量。统计并发症发生情况、下肢皮肤溃疡愈合率及大隐静脉主干闭合率。结果186例高龄患者均通过超声引导于局部肿胀麻醉下完成下肢静脉日间手术,其中,采用单纯大隐静脉主干射频消融术患者56例,采用大隐静脉主干射频消融术加小腿曲张静脉消融术(硬化剂腔内闭合+点式剥脱)患者130例。全部患者的手术时间为(32.0±6.0)min,术中出血量为(5.0±2.0)ml,肿胀麻醉液使用量为(380.0±30.0)ml。小腿肌间静脉血栓12例,浅静脉炎35例,皮炎27例,皮肤感觉异常3例,色素沉着21例,皮肤瘀斑79例。术后3个月溃疡愈合率为100%。术后1年内超声复查结果显示,大隐静脉主干闭合率为100%。结论高龄患者行下肢静脉曲张日间手术是安全可行的,围手术期并发症少,溃疡愈合率高,有利于生活质量的改善。
objective To investigate the safety and feasibility of day surgery for elderly patients with varicose vein of the lower extremities.Method The clinical data of 186 elderly patients undergoing day surgery for radiofrequency ablation of lower extremity varicose vein who were admitted to Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University from January 2016 to September 2019 were collected.The patients were followed up 3 days,1 month,3 months,and 1 year after surgery to evaluate the success rate,operation time,intraoperative blood loss and anesthesia swelling fluid,postoperative pain degree,complications,lower extremity ulcer healing rate and great saphenous vein closure rate.Result Day surgery for varicose veins of lower extremities under ultrasound-guided local anesthesia was successfully performed in all 186 elderly patients,with 56 cases of simple radiofrequency ablation of great saphenous vein trunk and 130 cases of simple radiofrequency ablation of great saphenous vein and varicose vein ablation of lower extremity(endovenous closure with sclerosing agent+spot denudation).The average operation time,intraoperative blood loss and anesthesia swelling fluind were(32.0±6.0)min,(5.0±2.0)ml and(380.0±30.0)ml,respectively.Complications included 12 cases of calf muscle venous thrombosis,35 cases of superficial phlebitis,27 cases of dermatitis,3 cases of skin paresthesia,21 cases of pigmentation and 79 cases of ecchymosis.The ulcer healing rate was 100%3 months after surgery.The saphenous vein closure rate was 100%by ultrasonography 1 year after surgery.Conclusion It is safe and feasible for elderly patients with varicose vein of the lower extremity to undergo day surgery.The perioperative complications are low,ulcer healing rate is high,and quality of life can be improved.
作者
梁锴
陈欢欢
胡国华
张翔宇
柯雪鹰
刘启芳
朱越锋
Liang Kai;Chen Huanhuan;Hu Guohua;Zhang Xiangyu;Ke Xueying;Liu Qifang;Zhu Yuefeng(Department of Vein Center,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,Zhejiang,China;Department of Vascular Surgery,the Fourth Affiliated Hospital,Medical College of Zhejiang University,Yiwu 322000,Zhejiang,China)
出处
《血管与腔内血管外科杂志》
2022年第1期43-46,50,共5页
Journal of Vascular and Endovascular Surgery
基金
浙江省卫生健康科技计划项目(2022ZH036)。
关键词
下肢
静脉曲张
日间手术
高龄
射频消融术
安全性
lower extremity
varicose vein
day surgery
old age
radiofrequency ablation
safety
