腔内激光联合皮下环缝术治疗重度大隐静脉曲张效果观察

目的 探究腔内激光联合皮下环缝术治疗重度大隐静脉曲张的效果及其临床意义.方法 选取2014年12月—2016年6月上海浦东新区浦南医院普外科住院的重度大隐静脉曲张患者120例,按照治疗方法不同分成观察组和对照组,每组60例.对照组给予腔内激光术治疗,观察组在对照组基础上联合皮下环缝术治疗.观察记录并比较两组手术时间及出血量,术后疼痛水平、住院时间及手术满意度,术后1周皮下血肿大小,术后16周生活质量,术后不同时间段舒适评级及美容效果评分.结果 与对照组比较,观察组手术时间及出血量显著增加(P<0.05),术后VAS评分及住院时间显著减少(P<0.05),术后满意度显著提高(P<0.05),术后1周血肿显著缩小(P<0.05),术后16周生活质量评分显著提高(P<0.05).两组舒适度评分术后16周高于术后1、4周(P<0.05),术后4周高于术后1周(P<0.05);两组美容效果评分术后16周高于术后4周(P<0.05).观察组术后不同时间舒适度评分均显著高于对照组(P<0.05),术后4、16周美容评分也显著高于对照组(P<0.05).结论 腔内激光联合皮下环缝术治疗重度大隐静脉曲张取得了较好的效果,具有较高的临床推广应用价值.

Curative Effect of Endovenous Laser Combined with Percutaneous Continuous Circumsuture in Treatment of Se-vere Great Saphenous Varicose Vein

Objective To investigate curative effect and clinical significance of endovenous laser therapy ( EV-LT) combined with percutaneous continuous circumsuture ( PCCS) in treatment of severe great saphenous varicose vein. Methods A total of 120 patients with severe great saphenous varicose vein were divided into observation group and con-trol group according to different treatment methods ( n=60 for each group) . Control group was treated with EVLT, while observation group received EVLT combined with PCCS. Operative time, intraoperative bleeding volume, postoperative pain degree, hospital stay, surgical satisfaction degree, hematoma size in 1 week after the operation, quality of life score in 16 weeks after the operation, score of comfort level and cosmetic result in postoperatively different times were observed and compared in two groups. Results Compared with those in control group, in observation group, values of operative time and intraoperative bleeding volume were significantly increased (P<0. 05);values of visual analogue scales (VAS) score and hospital stay were significantly decreased ( P<0. 05 ); surgical satisfaction degree was significantly improved (P<0. 05);hematoma size in one week after the operation was significantly decreased (P<0. 05);quality of life score in 16 weeks after the operation was significantly improved (P<0. 05). In two groups, scores of comfort level in 16 weeks after the operation were significantly higher than those in 1 and 4 weeks after the operation (P<0. 05), and the scores in 4 weeks after the operation were significantly higher than those in 1 week after the operation (P<0. 05);scores of cos-metic result in 16 weeks after the operation were significantly higher than those in 4 weeks after the operation ( P <0. 05). Scores of comfort level in different times after the operation were significantly higher (P<0. 05), and scores of cosmetic result in 4 and 16 weeks after the operation were also significantly higher in observation group than those in con-trol group, (P<0. 05). Conclusion EVLT combined with PCCS in treatment of severe great saphenous varicose vein can achieve good efficacy.