天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (10): 1040-1043.doi: 10.11958/20170551

• 临床研究 • 上一篇    下一篇

腔内激光闭合术联合皮下环缝术治疗重度 大隐静脉曲张的疗效观察

陶国强 1，曹明华 2，章彬 1△，司云飞 1，娄丙祥 1，韩琪 1，汪加宽 1   

  1. 1 上海市浦东新区浦南医院普外科（邮编 200125）；2 上海市第七人民医院普外科
  • 收稿日期:2017-05-08 修回日期:2017-07-09 出版日期:2017-10-15 发布日期:2017-10-13
  • 通讯作者: 陶国强 E-mail:tgq1970@aliyun.com
  • 作者简介:陶国强（1970），男，本科，副主任医师，主要从事临床普外科疾病的研究
  • 基金资助:
    上海市卫计委课题

Therapeutic effect of endovenous laser ablation combined with percutaneous continuous circumsuture on severe great saphena varicose

TAO Guo-qiang1, CAO Ming-hua2, ZHANG Bin1△, SI Yun-fei1, LOU Bing-xiang1, HAN Qi1, WANG Jia-kuan1   

  1. 1 Department of General Surgery, Shanghai Pu’nan Hospital of Pudong New District, Shanghai 200125, China; 2 Department of General Surgery, Shanghai Seventh People’s Hospital
  • Received:2017-05-08 Revised:2017-07-09 Published:2017-10-15 Online:2017-10-13

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摘要： 目的 比较激光腔内闭合术（EVLA）联合经皮浅静脉环形缝扎术（PCCS）与单独应用 EVLA 治疗重度大隐 静脉曲张的疗效。方法 临床病因病理生理解剖分类系统（CEAP）分级 C5~C6 级的单侧大隐静脉曲张患者 60 例， 随机均分为对照组与观察组，对照组行 EVLA，观察组采用 EVLA+PCCS，比较 2 组手术时间、住院时间、术中出血量， 计算术后 6 个月内 2 组溃疡愈合率、曲张静脉再通或复发和术后并发症发生率。结果 观察组平均手术时间与术 中出血量均少于对照组（P＜0.05），2 组住院时间、溃疡愈合率及曲张静脉再通或复发率差异无统计学意义。2 组患 者治疗后均未发生深层静脉血栓，观察组发生皮肤灼伤和皮下瘀斑硬结的比例低于对照组（P＜0.05），其他并发症发 生率差异均无统计学意义（P＞0.05）。结论 EVLA 联合 PCCS 治疗重度大隐静脉曲张可显著缩短手术时间，减少出 血量，在保持手术治愈率及低复发率的前提下可降低皮肤灼伤和皮下生成瘀斑硬结，安全有效，总体效果优于单独 应用 EVLA 治疗。

关键词: 大隐静脉曲张, 腔内激光闭合术, 皮下环缝术

Abstract: Objective To explore the therapeutic effects of endovenous laser ablation (EVLA) combined with percutaneous continuous circumsuture (PCCS) and EVLA in treating severe great saphena varicose. Methods A total of 60 patients with unilateral great saphenous varicose level C5 - C6 were randomly divided into control group and experimental group according to the CEAP system. Control group was given EVLA surgery while experimental group was given EVLA+ PCCS surgery. Data of operation time, hospital stay, intraoperative blood loss, the rate of ulcer healing, variceal recurrence rate and postoperative complication rate within 6 months after operation were compared between two groups. Results The mean operative time and intraoperative blood loss were lower in the experimental group than those in the control group (P< 0.05). There were no significant differences in hospital stay, ulcer healing rate and recurrence rate between two groups (P> 0.05). No deep venous thrombosis was found after treatment in two groups. The occurrence rates of skin burns and subcutaneous ecchymosis were significantly lower in the experimental group than those in the control group (P<0.05). There were no significant differences in the incidence rates of other complications between two groups (P＞0.05). Conclusion EVLA combined with PCCS in the treatment of severe saphenous varicose veins can significantly shorten the operation time, reduce the amount of bleeding, reduce the incidence rates of skin burns and subcutaneous ecchymosis on the premise of promising cure rate and recurrence rate. Overall, the combination therapy is superior than monotherapy.

Key words: great saphena varicose, endovenous laser ablation, percutaneous continuous circumsuture