对比腔内微波消融与大隐静脉高位结扎及剥脱术治疗下肢静脉曲张效果

目的 对比分析腔内微波消融（EMA）与大隐静脉高位结扎及剥脱术（简称传统剥脱术）治疗下肢静脉曲张的效果。方法 回顾性分析94例单侧下肢静脉曲张患者，其中45例接受超声引导下EMA治疗（EMA组）、49例接受传统剥脱术（传统组）；记录并比较2组手术时间、术中出血量、手术切口数量、住院时间及术后并发症，并于术后6及12个月行临床严重程度评分（VCSS）和阿伯丁静脉曲张问卷（AVVQ）评分以评估疗效。结果 94例均治疗成功。EMA组手术时间及住院时间较传统组短，术中失血量及切口数量均少于传统组（P均<0.05）。组间术后并发症皮下淤血、皮下血肿及皮肤灼伤发生率差异均有统计学意义（P均<0.05），局部感觉异常及切口感染发生率差异均无统计学意义（P均>0.05）。术前及术后组间VCSS、AVVQ评分差异均无统计学意义（P均>0.05）。术后6及12个月，2组VCSS及AVVQ评分均较术前降低（P均<0.05）。结论 EMA与传统剥脱术治疗下肢静脉曲张效果相当，前者安全性更高。

Comparison on efficacy of endovenous microwave ablation and high ligation plus stripping of great saphenous vein for lower extremity varicose veins

Objective To comparatively analyze the efficacy of endovenous microwave ablation (EMA) and high ligation plus stripping of great saphenous vein (traditional stripping surgery) for lower extremity varicose veins. Methods Data of 94 patients with unilateral lower extremity varicose veins were retrospectively analyzed. Among 94 patients, 45 underwent ultrasound-guided EMA (EMA group) and 49 underwent traditional stripping surgery (traditional group). The operation time, intraoperative blood loss, number of surgical incisions, hospital stay and postoperative complications were recorded and compared between groups. Then clinical severity score (VCSS) and Aberdeen varicose vein questionnaire (AVVQ) scoring were performed 6 and 12 months after operation to assess the efficacy of treatment. Results All operatations were successfully performed. The operation time and hospital stay of EMA group were shorter than those of traditional group, and the intraoperative blood loss and the number of incisions in EMA group were less than those in traditional group (all P<0.05). There were significant differences of the incidence rate of postoperative complications, including subcutaneous congestion, subcutaneous hematoma and skin burns (all P<0.05), but not of the incidence of local paresthesia nor incision infection between groups (both P>0.05). There was no significant difference of VCSS nor AVVQ scores before and after operation between groups (all P>0.05). Six and 12 months after operation, the VCSS and AVVQ scores decreased in both groups compared with those before operation (all P<0.05). Conclusion Compared with traditional stripping surgery, EMA had comparable efficacy and higher safety for treating lower extremity varicose veins.