小切口联合钬激光治疗大隐静脉曲张的效果

目的观察小切口联合钬激光治疗大隐静脉曲张的临床效果。方法选择2011年1月～2013年1月秦皇岛市第二医院血管外科治疗的大隐静脉曲张患者256例（298条患肢），随机分为观察组和对照组，观察组128例（152条患肢），对照组128例（146条患肢）。观察组采用小切口联合钬激光微创治疗，对照组采用传统大隐静脉高位结扎加抽剥术。比较两组的治疗效果及并发症、1年复发率。结果观察组手术时间、术后下床活动时间、住院时间均短于对照组，差异有统计学意义（P〈0．05）；观察组切口数量少于对照组，两组比较差异有统计学意义（P〈0．05）；观察组术后疼痛发生率低于对照组，两组比较差异有统计学意义（P〈0．05）。观察组并发症发生率为7．8％（10／128），低于对照组的12．5％（16／128），差异有统计学意义（P〈0．05）；观察组1年复发率为4．7％（6／128），与对照组的3．9％（5／128）比较差异无统计学意义（P〉0．05）。结论小切口联合钬激光治疗大隐静脉曲张手术创伤小。术后美观，恢复快，同时应密切关注术后并发症，采取合理的预防和处理措施。

Effect of small incision combined with holmium laser in the treatment of varicose great saphenous veins

Objective To observe the clinical effects of small incision combined with holmium laser in the treatment of varicose veins. Methods 256 cases （298 limbs） patients with varicosis of great saphenous vein from January 2011 to January 2013 in Department of Vascular Surgery, the Second Hospital of Qinhuangdao City were selected and randomly divided into observation group and control group, 128 cases （152 limbs） were in the observation group, 128 cases （146 limbs） in the control group. The observation group was treated with small incision combined with holmium laser treatment, the control group was treated with the traditional high ligation and pumping stripping operation on great saphenous vein. The clinical effects, complications and recurrence rate of the two groups were compared respectively. Resuits The operation time, postoperative ambulation time, hospitalization time in observation group was shorter than those of the control group respectively, the differences were statistically significant （P 〈 0.05）; the number of incision in observation group was less than that in the control group, the difference was statistically significant （P 〈 0.05）. The occurrence rate of pain after the operation of observation group was lower than that of the control group, the difference was statistically significant （P 〈 0.05）. The incidence of complications of observation group was 7.8% （10/128）, which was lower than that of the control group 12.5% （16/128）], the difference was statistically significant （P 〈 0.05）. The 1 year recurrence rate of observation group was 4.7% （6/128）, and was 3.9% （5/128） in the control group, the difference was not statistically significant （P 〉 0.05）. Conclusion The small incision combined with holmium laser treatment for varicose great saphenous veins operation has little trauma, postoperative appearance, faster postoperative recovery, at the same time, it is right to pay cl6se attention to the postoperative complications, and adopt the reasonable prevention and treatment measures.