透光旋切术与传统手术治疗下肢浅静脉曲张的对比研究

目的比较透光旋切术与传统分段剥脱切除术治疗下肢静脉曲张的疗效。方法研究组53例静脉曲张患者(78条患肢),采用Trivex系统透光旋切术治疗曲张血管;对照组53例(76条患肢)采用分段剥脱切除术。比较两组手术时间、术后开始下床活动时间、切口数、切口长度、皮下血肿、感觉异常或麻木发生率、残留曲张静脉、复发率等指标。结果研究组手术时间、术后开始下床活动时间、切口数、切口长度及残留曲张静脉分别为(53.7±2.3)mm,(26.8±0.7)h,(4.1±0.2)个,(6.2±0.2)cm,对照组分别为(74.6±2.6)min,(42.3±0.9)h,(5.2±0.2)个,(10.4±0.2)cm,组间比较有显著差异(P0.05)。研究组残留曲张静脉为0,明显优于对照组的7.9%(P0.05)。两组皮下血肿、感觉异常或麻木发生率比较,无显著性差异(P0.05)。平均随访13.9个月(2个月～2年),研究组无复发病例,对照组复发5例(6.6%),组间比较差异显著(P0.05)。结论 Trivex系统透光旋切术治疗下肢静脉曲张临床综合疗效明显优于传统手术方法,具有微创、美观、恢复快、治疗彻底、不易复发且简单安全等优点。

Comparison of Transilluminated Powered Phlebectomy and Traditional Surgery for Superficial Varicose Vein of Lower Limbs

Objective To compare the curative effect of transilluminated powered phlebectomy（Trivex operation） and segmented stripping in treatment of varicose vein of lower extremity.Methods The study group with 53 patients（78 affected limbs） was performed Trivex operation,while the control group with 53 patients（76 affected limbs） was performed traditional surgery of segmented stripping.The operation duration,time of out-of-bed activity,amount of incision,length of all incisions,limb numbers of residual affected varicose vein,subcutaneous hematoma,paresthesia/numbness and recurrence were compared by unpaired t-test or chi-square test between two groups.Results The operation duration,time of out-of-bed activity,amount of incision and length of all incisions was（53.7±2.3） minutes,（26.8±0.7） hours,4.1±0.2 and（6.2±0.2） cm respectively in study group,all of them were significantly lower than（74.6±2.6） minutes,（42.3±0.9） hours,5.2±0.2 and（10.4±0.2） cm respectively in control group（P0.05）.The limb of residual affected varicose vein of study group was 0,and was superior to 7.9%（5/76） of control group（P0.05）.There was no statistic difference in the incidence of subcutaneous hematoma and paresthesia/numbness between two groups（P0.05）.All cases were followed up for 2 months to 2 years with an average of 13.9 months.There was remarkable difference of recurrence between study group and control group（0 VS 6.6%,P0.05）.Conclusion The Trivex operation is a simple and safe procedure for lower extremity varicose veins,and is superior to traditional operation with advantages such as minimal invasion,less incisions,few scars,quicker recovery and lower recurrence rate.