腔内射频消融术联合硬化剂注射对下肢静脉曲张病人症状改善及下肢血流动力学的影响
Effects of intracavitary radiofrequency ablation combined with sclerotherapy injection on symptom improvement and lower limb hemodynamics in patients with lower limb varicose veins
杨伟光 1王海静 2米沼橦 1张新花1
作者信息
- 1. 056000 河北省邯郸市中心医院心血管外科
- 2. 056000 河北省邯郸市中心医院呼吸与危重症医学科一病区
- 折叠
摘要
目的 探讨腔内射频消融术联合硬化剂注射对下肢静脉曲张病人症状改善及下肢血流动力学的影响.方法 2022年1月～2023年1月下肢静脉曲张病人100例,依据手术方法将病人分为R组和S组,每组各50例.S组行传统大隐静脉高位结扎术+剔剥术,R组行腔内射频消融闭合术+超声引导泡沫硬化剂注射+点式剥脱术.比较两组病人手术期间临床情况、手术前后下肢血流动力学指标,术后3个月的疗效,术前、术后3个月、术后6个月静脉临床严重程度评分(VCSS)、静脉分类系统(CEAP)分级以及术后6个月并发症发生情况.结果 术后3个月,R组总有效率(90.00％)高于S组(74.00％),差异有统计学意义(P＜0.05).R组病人住院时间、下床时间和术中出血量低于S组,术后72小时内VAS评分高于S组,差异有统计学意义(P＜0.05).与术前比较,两组病人术后股深静脉、腘静脉、髂外静脉血流速度均显著上升,差异有统计学意义(P＜0.05);且R组更高(P＜0.05).两组术后3个月、术后6个月VCSS、CEAP分级差值比较,差异有统计学意义(P＜0.05).术后6个月R组不良反应发生率与S组比较,差异无统计学意义(P＞0.05).结论 腔内射频消融术联合硬化剂注射对下肢静脉曲张病人具有较好的治疗效果,可有效改善病人病情,减少血流动力学影响,维持血流动力学的稳定性,具有较高的安全性.
Abstract
Objective To explore the effects of intracavitary radiofrequency ablation combined with sclerotherapy injection on symptom improvement and lower limb hemodynamics in patients with lower limb varicose veins.Methods Clinical data of 100 patients with lower extremity varicose veins treated in our hospital from January 2022 to January 2023 were retrospectively selected.According to the surgical method,the patients were divided into R group and S group,50 cases in each group.Traditional high ligation of great saphenous vein+exfoliation was performed in group S,intracavity radiofrequency ablation closure+ultrasound guided injection of foam sclerosing agent+spot exfoliation was performed in group R.The clinical status,lower extremity hemodynamic indexes before and after surgery,therapeutic effect 3 months after surgery,venous clinical severity score(VCSS),venous classification system(CEAP)grading before,3 months after and 6 months after surgery,and the occurrence of complications 6 months after surgery were compared between the two groups.Results Three months after surgery,the total effective rate in group R(90.00％)was obviously higher than that in group S(74.00％)(P＜0.05).The hospital stay,bedtime,and intraoperative bleeding in group R were obviously lower than those in group S,and the VAS score within 72 hours after surgery was obviously higher than that in group S(P＜0.05).Compared with preoperative,postoperative blood flow velocity of femoral deep vein,popliteal vein and external iliac vein in 2 groups was significantly increased(P＜0.05).The R group was higher(P＜0.05).The difference of VCSS score and CEAP score 3 months and 6 months after surgery between the two groups was statistically significant(P＜0.05).There was no statistically obvious difference in the incidence of adverse reactions between group R and group S at 6 months after surgery(P＞0.05).Conclusion Intraluminal radiofrequency ablation combined with hardener injection has a good therapeutic effect on patients with lower limb varicose veins,which can effectively improve the patient's condition,reduce hemodynamic effects,maintain hemodynamic stability,and have high safety.
关键词
下肢静脉曲张/腔内射频消融术/硬化剂/疗效/血流动力学Key words
lower limb varicose veins/intraluminal radiofrequency ablation/hardener/efficacy/hemodynamics引用本文复制引用
出版年
2024
NETL
NSTL
万方数据