激光微创治疗下肢静脉曲张疾病

目的探讨激光微创治疗下肢静脉曲张疾病的适应证和手术方法。方法大隐静脉曲张患者420例（525条肢体），其中单纯性大隐静脉曲张324例（422条肢体），下肢深静脉瓣膜功能不全96例（103条肢体）。分别采用单纯激光治疗、激光加小切口静脉团点状剥脱和激光治疗联合股浅静脉戴戒术。结果患者术后恢复良好。患肢无切口的有126条（占24．0％），小腿仅有1～3个1．0～2．0em小切口的有216条（占41．1％），大腿根部有切口（包括103条做戴戒术的肢体）的183条肢体（占34．8％）。随访3—40个月，共随访380例（占90．5％），单纯性大隐静脉曲张者术后有27条肢体复发（复发率6．4％），下肢深静脉瓣膜功能不全者术后有8条肢体复发（复发率7．8％）。结论激光微创治疗下肢静脉曲张疾病手术简单、创伤小，基本不影响下肢的美观，易为患者接受。术者应掌握好手术适应证和合理地选择手术方法。

Laser Minimally Invasive Treatment for Varicosis of Lower Limbs

Objective To explore the indications and operative methods of treating varicosis of lower limbs with endovenous laser energy.Methods There were 420 patients(525 limbs) with great saphenous vein(GSV) varicose,of which 324 cases(422 limbs) were with pure GSV varicose and 96(103 limbs) coexisted primary deep venous insufficiency(PDVI) of lower limbs,to undergo respectively only laser treatment,laser combined with varicose vein mass resection in the calf or laser with operation of superficial femoral vein wearing ring.Results All patients recovered well after operation.There were no slits in 126 limbs(24.0%),only 1 to 3 slits with 1.0-2.0 cm long on calf in 216 limbs(41.1%) and one slit on the root of big leg in 183 limbs(34.8%).Totally 380 patients(90.5%) took in follow-up from 3 to 40 months.Twenty seven limbs(recurrence rate 6.4%)with pure GSV varicose and 8(recurrence rate 7.8%) with PDVI were diagnosed postoperative recurrence.Conclusions Laser treatment for varicosis of lower limbs is a method which can easily get patient acceptance because the operation is simple,minimally invasive,and has not much affect on the leg look,but surgeon should hold well laser treatment indications and rightly choose operation methods.