DSA引导泡沫硬化治疗下肢静脉曲张中长期效果

目的 观察DSA引导泡沫硬化治疗下肢静脉曲张的效果及对患者生活质量的影响。方法 对573例（744肢）下肢静脉曲张患者行泡沫硬化治疗；随访4年，统计治疗前和治疗后1、2、3、4年健康调查12条简表（SF-12）评分及静脉疾病临床严重程度评分（VCSS），4年后填写下肢症状改善情况问卷，记录期望值达到情况及治疗满意度。结果 所有患肢治疗均成功，平均泡沫硬化剂用量为每肢（21.62±10.83）ml；治疗中及治疗后均未见深静脉血栓、肺栓塞等严重并发症。治疗后1、2、3、4年SF-12中躯体健康成分（PCS）总分和精神健康成分（MCS）总分均较术前增加（P均<0.05），VCSS均较术前降低（P均<0.01）。治疗后4年患者对患肢外观、疼痛、瘙痒、肿胀及沉重感改善超过预期+达到预期者分别占100%（91/91）、100%（36/36）、93.55%（29/31）、88.46%（23/26）及91.38%（53/58）；患者满意度100%（72/72）。结论 DSA引导泡沫硬化治疗下肢静脉曲张中长期疗效较好，并可改善患者生活质量。

Medium-and long-term effects of DSA-guided foam sclerotherapy for lower extremity varicosities

Objective To observe the effect of DSA-guided foam sclerotherapy for lower extremity varicose veins and its influence on patients'' quality of life. Methods Totally 573 patients (744 limbs) with lower extremity varicosities were treated with DSA-guided foam sclerotherapy and were followed up for 4 years. The health survey short form 12 (SF-12) and venous clinical severity score (VCSS) were counted before treatment and 1, 2, 3 and 4 years after treatment. The expectation for efficacy and treatment satisfaction were collected through filling questionnaires for the lower extremity symptom improvement 4 years after treatment. Results All the limbs were successfully treated, the average usage of the foam was (21.62±10.83) ml/limb, and no severe side effects such as deep venous thrombosis or pulmonary embolism happened during or after procedures. Both physical component summary (PCS) score and mental component summary (MCS) score in SF-12 scale increased 1, 2, 3 and 4 years after treatment compared with that before treatment (all P<0.05), while VCSS decreased compared with that before treatment (all P<0.01). Upon the time of 4-year follow-up, the proportions of patients'' expectations for improvement of appearance, pain, itching, swelling and heaviness of the affected limbs exceeded expectations + reached expectations were 100% (91/91), 100% (36/36), 93.55% (29/31), 88.46% (23/26) and 91.38% (53/58), respectively. The patients'' overall satisfaction on the treatment was 100% (72/72). Conclusion The medium- and long-term efficacy of DSA-guided foam sclerotherapy for lower extremity varicose veins were good, and the quality of life was improved.