超声引导下血管腔内射频消融联合局部点式剥脱治疗下肢静脉曲张

目的 观察超声引导下血管腔内射频消融联合点式剥脱治疗下肢静脉曲张的效果。方法 回顾性分析接受腔内射频消融联合点式剥脱治疗下肢静脉曲张的373例患者共397条下肢静脉(单侧349例、双侧24例),包括大隐静脉384条、小隐静脉13条,观察治疗中及治疗后不良反应;记录治疗后随访复查静脉彩色多普勒超声所见,评估静脉闭合率。结果 对373例397条静脉均顺利完成治疗,技术成功率100%(397/397)。治疗中不良反应主要包括穿刺及肿胀麻醉过程中轻度疼痛;治疗后6例切口明显渗血、3例局部血肿、2例切口局部感染,经相应治疗后均好转;治疗后1个月1例发生肺栓塞,予抗凝治疗后缓解。治疗后1、6、12个月,经治下肢曲张静脉闭合率分别为99.24%(394/397)、100%(307/307)及100%(217/217);治疗后随访2~5年,期间6例下肢局部新发曲张静脉,予以剥脱处理,1例溃疡愈合后再次复发,予局部换药。结论 血管腔内射频消融联合点式剥脱治疗下肢静脉曲张安全、有效。

Ultrasound-guided endovascular radiofrequency ablation combined with local point stripping for treating lower extremity varicose veins

Objective To observe the efficacy of ultrasound-guided endovascular radiofrequency ablation combined with local point stripping for treating varicose veins of lower extremity. Methods Data of 373 patients with varicose veins of lower extremities who underwent endovascular radiofrequency ablation combined with point stripping of 397 veins (349 unilateral and 24 bilateral), including 384 great saphenous veins and 13 small saphenous veins were retrospectively analyzed. The adverse reactions during and after treatment were observed. Regular follow-up was performed after treatment, the venous closure rate of lower limbs was evaluated using color Doppler ultrasonography. Results All 397 veins in 373 patients were successfully treated, with a technical success rate of 100% (397/397). The adverse reactions during treatment mainly included mild pain during puncture and swelling anesthesia. After treatment, incision bleeding occurred in 6 cases, local hematoma happened in 3 cases and local incision infection developed in 2 cases, all were improved after corresponding treatments. One month after treatment, pulmonary embolism occurred in 1 case and relieved after anticoagulant treatment. The venous closure rates of lower extremity was 99.24% (394/397), 100% (307/307) and 100% (217/217) 1, 6 and 12 months after treatment, respectively. During 2 to 5 years'' follow-up, local new varicose veins of lower limbs were noticed in 6 cases and treated with exfoliation, while recurrence ulcer was observed in 1 case after healing and treated with local changes of dressing. Conclusion Endovascular radiofrequency ablation combined with local point stripping was safe and effective for treating lower extremity varicose veins.