激光和微波腔内闭合术治疗大隐静脉曲张的临床研究

目的：探讨激光和微波腔内闭合术治疗大隐静脉曲张的疗效和并发症。方法：上海交通大学附属第一人民医院血管外科自2007年9月—2009年8月间收治249例（295条肢体）大隐静脉曲张手术患者,其中138例（163条肢体）实施激光闭合术,111例（132条肢体）实施微波闭合术,对比2组的临床疗效、再通率和并发症发生率。结果：激光组的手术耗时少于微波组（27.5±6.3min比22.7±5.6min,P〈0.01）,激光组的术中出血亦少于微波组（15.8±2.5mL比12.5±2.3mL,P〈0.05）,微波组的3个月及1年再通率低于激光组（0.76%比2%及1.5%比6.5%）,2组的Aberdeen评分改善值和住院天数基本相当,组织灼伤、皮下硬结、瘀斑、表皮麻木等并发症率在2组间无显著差异,2组病例均未出现肺栓塞等严重并发症。结论：微波和激光腔内闭合术都是治疗下肢静脉曲张安全有效的微创手术方法。

Endo-Venous Ablation in Treatment of Veins Varicoses by Laser and Microwave

Objective：To study the efficacy and complication of endo-venous laser or microwave ablation in the treatment of vein varicoses of lower limb.Methods： From Sep.2007 to Aug.2009,249 chronic venous insufficiency（CVI） cases（295 limbs） were devided into laser group（138 cases,163 limbs） and microwave group（111 cases,132 limbs）.The difference of outcome,ratio of recanalization and comlication between two groups is analysed.Results： Less operation time consuming and bleeding were achieved in laser group than that of in microwave group,（27.5±6.3 min vs 22.7±5.6 min P〈0.01 and 15.8±2.5 mL vs12.5±2.3 mL,P〈0.05）wherever the ritio of recanalization three months and one year after operation was statistically higher in laser group than that in the microwave group.（0.76% vs 2%及1.5% vs 6.5%） The Aberdeen score improvement,length of hospital stay and ratio of complications as for burn hurt,ecchymosis,paralysis and subcutaneous scleroma are approximative between the two groups.Conclusions： Endo-venous ablation is safe and effcacy for treatment of CVI,whether laser or microwave is employed.