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目的 探讨腔内激光治疗下肢浅静脉曲张术后复发的原因及防治方法.方法 回顾性分析353例(415条肢体)下肢静脉曲张患者的临床资料.结果 38例(40条肢体)患者术后复发,复发率为9.64%.复发原因分别为:18条肢体交通支功能不全,14条肢体大隐静脉主干再通,5条肢体小隐静脉主干未处理,2条肢体深静脉瓣膜功能不全,1条肢体双大隐静脉畸形.38例患者均经再次手术,分别随访1~4年无复发.结论 根据静脉曲张程度和病因采取针对性手术,重视过度扩张大隐静脉的高位结扎和交通支血管的处理是预防术后复发的关键. 相似文献
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下肢静脉造影分析静脉曲张术后复发原因 总被引:9,自引:0,他引:9
目的:探讨下肢静脉曲张术后复发的原因。材料和方法:回顾性分析1997年1月至2001年12月诊治的83例(89例)下肢静脉曲张术后复发病例资料,静脉顺行造影池解下肢深、浅静脉和交通支瓣膜功能。结果:静脉造影显示深静脉瓣膜功能不全59.55%(53/89),交通支瓣膜功能不全64.04%(57/89),大隐静脉主干残留19.10%(17/89),深静脉血栓形成后遗症14.61%(13/89),静脉发育异常1.12%(1/89)。结论:下肢静脉曲张是深、浅静脉和交通支静脉功能不全的共同临床表现,术前静脉造影可明确疾病性质,从而选择正确的手术方式,避免术后复发。 相似文献
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近20年来,我们收治大隐静脉曲张术后复发26例。1 临床资料1.1 一般情况 本组男18例,女8例;年龄19~65岁。术后复发时间:6个月内2例,7个月~1年16例,2年3例,3年1例,4年2例,6年1例,14年1例。1.2 复发原因分析1.2.1 切口选择不当 切口偏外上方,距大隐静脉解剖位置约3cm,术中显露大隐静脉及所属分支受到限制。本组3例。1.2.2 分支未全部结扎 遗漏分支后,股静脉血流通过瓣膜关闭不全的大隐静脉逆流入分支,致分支逐渐增粗扩张,并与大隐静脉之间重新建立侧支循环。术后1年复发,再次手术发现分支明显增粗,最大直径约3mm。本组5例。1.2.3 大… 相似文献
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目的评价导管引导下激光治疗下肢静脉曲张的可行性及有效性。方法 2011年8月—2012年8月收治30例(33条下肢)原发性下肢静脉曲张患者,在导管引导下施行激光治疗。术后随访4~16个月,平均随访(8.20±3.77)个月,观察疗效及术后并发症。结果全部患者都成功耐受激光腔内治疗,单肢时间(45.0±15.4)min。术后住院时间(3.17±0.87)d。随访时患肢沉重感、皮肤色素沉着和湿疹样改变、皮肤溃疡显著减轻或消失,无静脉曲张复发或残留。结论导管引导下激光治疗大隐静脉曲张安全可行、疗效满意、具有恢复快和瘢痕小的优点。 相似文献
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目的评价激光治疗下肢静脉曲张技术改进后的疗效。方法206例下肢静脉曲张患者,共251条肢体。86例(114条患肢)采用腔内激光结合高位结扎治疗;120例(137条患肢)在原腔内激光结合高位结扎治疗的基础上操作技术改进后进行治疗。结果操作方法改进后治疗的120例患者,激光治疗前期的并发症明显减少,下肢皮下淤斑的出现率由技术改进前的91.9%降为9.2%,静脉周围硬块由技术改进前的54.7%降为19.2%,切口瘢痕减少。多普勒彩超复查显示,本组206例251条肢体大隐静脉主干完全闭塞,血管内无血流信号,无1例复发。结论腔内激光结合高位结扎治疗下肢静脉曲张操作技术改进后,术后损伤更小、更美观、恢复更快,取得了更为满意的疗效。 相似文献
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MEBO联合激光治疗下肢静脉曲张性溃疡 总被引:1,自引:0,他引:1
目的:探索下肢静脉曲张诱发下肢皮肤溃疡的治疗方法。方法:局部采用湿润烧伤膏(MEBO)包扎方法,共60例。结果:MEBO+激光治愈55例,MEBO+激光+皮片移植治愈5例,治愈率100%。结论:MEBO联合激光治疗下肢静脉曲张诱发溃疡安全易行,疗效满意。 相似文献
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下肢静脉曲张的介入治疗 总被引:6,自引:0,他引:6
下肢静脉曲张是一种常见病。可通过静脉内射频、激光血管消融术或血管硬化术等介入治疗的方法消融大隐静脉,以达到“剥脱”曲张静脉的目的,该方法具有损伤小、痛苦少、恢复快、复发率低的特点。 相似文献
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目的观察半导体激光和He-Ne激光在相同剂量条件下局部照射治疗原发性下肢静脉曲张性皮肤溃疡的临床疗效。方法选择原发性下肢静脉曲张性皮肤溃疡患者96例,随机分为半导体激光组和He-Ne激光组,每组患者48例。两组均扩束照射,能量密度均为2.4 J/cm^2,每日1次。治愈患者随访1-3年,统计复发情况。结果两组治疗结果比较,差异无显著意义(P〉0.05);溃疡面积组内比较,差异无显著意义(均P〉0.05);组间比较,溃疡面积〉10 cm^2者,半导体激光组疗效好于He-Ne激光组(P〈0.05),〈5 cm^2和5-10 cm^2者,差异均无显著意义(均P〉0.05);两组炎性反应消失及治愈天数比较,半导体激光组明显短于He-Ne激光组,差异具有显著意义(均P〈0.05);两组溃疡复发情况比较,差异无显著意义(P〉0.05)。结论半导体激光和He-Ne激光局部照射治疗原发性下肢静脉曲张性皮肤溃疡均有较好疗效。 相似文献
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腔内激光治疗下肢静脉曲张175例 总被引:1,自引:1,他引:0
下肢静脉曲张是血管外科的一种常见疾病,大隐静脉高位结扎并分段剥脱术是治疗该病的经典传统术式,但创伤大、切口多、欠美观。静脉腔内激光治疗(Endovenous laser treatment,EVLT)是治疗下肢静脉曲张的微创手术方法,2006—05~2007—12,我院应用英国Diomed公司生产的半导体激光治疗仪治疗下肢静脉曲张175例210条肢体,疗效满意。 相似文献
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静脉腔内激光术联合手术治疗下肢静脉曲张 总被引:9,自引:0,他引:9
目的探讨静脉腔内激光术治疗下肢静脉曲张的安全性、临床疗效、并发症及其防治措施。方法超声检查证明的隐股静脉返流的下肢静脉曲张患者198例(235条肢体),分别采取静脉腔内半导体激光术(EVLT)联合股浅静脉第一对瓣膜修复、大隐静脉高位结扎及交通支结扎术治疗。结果术后患者恢复良好,手术并发症主要包括皮肤灼伤18例,小腿皮肤麻木6例,皮下血肿7例。超声随访可见EVLT静脉管壁回声增强,管腔内充满实性回声,未见血流信号。随访4~28个月,其中6例在术后1~2个月出现小腿局部曲张静脉复发;其余均未见复发。结论EVLT联合手术是治疗下肢静脉曲张的安全、有效的方法,达到在保证疗效的前提下减小创伤的目的。 相似文献
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目的探讨静脉腔内激光疗法治疗下肢静脉曲张的临床疗效。方法回顾分析2009年6月至2010年6月100例124条肢体大隐静脉曲张行腔内激光治疗疗效及预后。结果一次治愈率95.2%(118/124)。1例1条肢体于术后1个月复发。5例5条肢体术后仍有少量曲张静脉存在。18例大隐静脉主干烧灼处条索状硬结、疼痛;15例发生皮下片状淤血;12例出现局部皮肤麻木。术后平均住院时间3 d。95例随访2~14个月,失访5例。结论腔内激光疗法治疗大隐静脉曲张疗效确切,创伤小。 相似文献
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S. D. Goode G. Kuhan N. Altaf R. Simpson A. Beech T. Richards S. T. MacSweeney B. D. Braithwaite 《Cardiovascular and interventional radiology》2009,32(5):988-991
The aim of the study was to assess the suitability of radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and
foam sclerotherapy (FS) for patients with symptomatic varicose veins (VVs). The study comprised 403 consecutive patients with
symptomatic VVs. Data on 577 legs from 403 consecutive patients with symptomatic VVs were collected for the year 2006. Median
patient age was 55 years (interquartile range 45–66), and 62% patients were women. A set of criteria based on duplex ultrasonography
was used to select patients for each procedure. Great saphenous vein (GSV) reflux was present in 77% (446 of 577) of legs.
Overall, 328 (73%) of the legs were suitable for at least one of the endovenous options. Of the 114 legs with recurrent GSV
reflux disease, 83 (73%) were suitable to receive endovenous therapy. Patients with increasing age were less likely to be
suitable for endovenous therapy (P = 0.03). Seventy-three percent of patients with VVs caused by GSV incompetence are suitable for endovenous therapy. 相似文献
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Ji-Chang Wang Yan Li Guang-Yue Li Yi Xiao Wei-Ming Li Qiang Ma Jian-Lin Liu Shao-Ying Lu 《Journal of vascular and interventional radiology : JVIR》2018,29(6):781-789
Purpose
To compare outcomes of patients who received simultaneous tributary endovenous laser ablation (EVLA) or foam sclerotherapy (FS) with EVLA of the great saphenous vein (GSV) trunk.Methods and Materials
This study recruited 418 patients (542 legs) with diagnosed varicose veins. Patients in the EVLA/FS group (255 patients, 327 legs) received concomitant FS for the tributaries with truncal lasering. For the EVLA-alone group (163 patients, 215 legs), tributaries (8W) were ablated with EVLA in addition to the GSV trunk (14W). Complications, Aberdeen Varicose Vein Questionnaire (AVVQ), EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D), numerical rating scale (NRS) scores, and condition of residual varicosities were assessed at 3 days, 4 weeks, and 6 months after procedure. All residual varicosities were identified and treated with a staged FS at 6 months.Results
Except for ecchymosis, incidence of other complications was not significantly different between both groups at 6 months. Pain NRS scores of the EVLA/FS group were remarkably elevated at 4 weeks and then, at 6 months, declined to a level similar to the EVLA-alone group. The EVLA/FS group exhibited more significant improvement in both AVVQ and EQ-5D scales than the EVLA group at 6 months, while exhibiting poor improvement at 4 weeks. The EVLA/FS group had a significantly lower rate of residual varicosities than the EVLA group, thus reducing the need for the staged FS.Conclusions
These results confirm the feasibility and safety of simultaneous tributary EVLA and FS. In addition, they indicate better early quality-of-life improvement and a reduced reoperation rate of simultaneously combined truncal EVLA and tributary FS. 相似文献16.
下肢静脉曲张性溃疡的临床治疗 总被引:1,自引:0,他引:1
目的:总结治疗下肢静脉曲张并发慢性溃疡的有效治疗方法.方法:自2002年3月至2007年3月,对35例下肢静脉曲张并发难治性小腿溃疡患者先采取曲张静脉手术治疗,而后采用湿润烧伤膏换药治疗(治疗组);23例曲张静脉不做手术处理,直接采用传统的生肌散外敷治疗(对照组).结果:治疗组溃疡创面全部治愈,平均愈合时间18d±9.3d,复发1例;对照组平均愈合时间28d±9.6d,复发8例,治疗组疗效明显优于对照组,P<0.01.结论:MEBO联合曲张静脉手术疗法,治疗难治性下肢静脉曲张性慢性溃疡的疗效优于单纯生肌散疗法. 相似文献
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目的探讨下肢静脉腔内激光治疗(Endovenous Laser Treatment,EVLT)联合大隐静脉(Great Saphenous Vein,GSV)高位结扎治疗原发性下肢静脉曲张术后是否需要抗凝治疗。方法本实验设计为前瞻性的随机对照临床研究,将原发性下肢静脉曲张患者189例,随机分为对照组(A组),患者96例;抗凝组(B组),患者93例。两组患者均进行静脉腔内激光治疗及大隐静脉高位结扎术,B组患者术后给予皮下注射低分子肝素,A组术后不给予低分子肝素,其它处理相同。观察两组患者术后3d、2周和3个月术肢有无深静脉血栓形成。所有患者随访时间3个月。结果189例原发性下肢静脉曲张患者,在术后随访期间,仅A组有1例发生术肢深静脉血栓形成(Deep Vein Thrombosis,DVT);其余无一例发生DVT和肺栓塞。A、B两组间术后下肢深静脉血栓形成发病率无显著性意义(P〉0.05)。结论腔内激光联合高位结扎治疗原发性下肢静脉曲张术后是否应用抗凝药物对预防下肢深静脉血栓形成没有显著性影响,术后不需要常规应用抗凝药物。 相似文献
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大隐静脉曲张腔内激光治疗后的并发症及其防治 总被引:3,自引:0,他引:3
目的 探讨大隐静脉曲张腔内激光治疗后的并发症及其防治.方法 对我院近3年来采用激光治疗的下肢静脉曲张316例的临床资料进行回顾性分析.结果 316例患者术后发生皮下淤血114例次;大隐静脉主干及小腿局部条索状硬结、红肿及严重疼痛17例次;隐神经损伤导致皮肤感觉异常89例次;皮肤灼伤29例次;溃疡合并感染1例,下肢深静脉血栓形成1例;经相应治疗后均痊愈.结论 大隐静脉曲张腔内激光治疗创伤较小、安全,但可发生并发症,应认真对待和处理. 相似文献
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Ethan A. Prince Gregory M. Soares MaryLou Silva Anil Taner SunHo Ahn Gregory J. Dubel Bryan S. Jay 《Cardiovascular and interventional radiology》2011,34(3):536-541
The design of laser fibers used for endovenous laser ablation (EVLA) in the management of lower-extremity varicose vein disease
may affect treatment success. The purpose of this investigation is to report our experience using the gold-tip NeverTouch
VenaCure laser fiber (AngioDynamics, Queensbury, NY) and to compare that to our experience with standard bare-tip fibers.
A retrospective chart review of 363 consecutive EVLA treatments using the gold-tip laser fiber was performed. Demographic
data including patient age, sex, history of previous varicose vein stripping, vein identity, laterality, treatment length,
total applied energy in joules (J), use of adjuvant sclerotherapy and ambulatory phlebectomy, treatment-related complications,
and treatment failure, which was defined as recanalization of any portion of the treated vein during follow-up as assessed
by duplex ultrasound examination―were entered into a spreadsheet. These data were compared with a control group of 471 EVLA
treatments performed with a standard bare-tip laser fiber. Data were analyzed using independent-samples Student’s t test, chi-square test, and multivariate analysis. Demographic data were similar between the two groups. Treatments with the
gold-tip fiber had a failure rate of 11.1%, whereas treatment with a bare-tip fiber had a failure rate of 2.3% during a similar
follow-up period. This difference was highly statistically significant (p < 0.0001). Multivariate analysis showed fiber type as the most significant factor associated with treatment failure. We conclude
that laser fiber design has a significant effect on treatment success in the performance of EVLA. 相似文献