腔内激光联合戴戒术治疗下肢深静脉功能不全

目的 :评价传统手术联合应用 DIOMED81 0 nm激光治疗下肢深静脉瓣膜功能不全的疗效。方法 :2 4例病人 (男 1 8,女 6) ,共 35条肢体 ,分别采用单纯激光治疗、股静脉瓣膜包窄术和交通静脉结扎等不同手术方式治疗 ,术后对病人进行随访观察 ,对临床资料整理分析。结果 :大部分病人于术后早期发现有沿大隐静脉走行的条索状硬结或曲张静脉处血栓样结节现象 ,一般于 4～ 8周内逐渐消退。 2例病人有足靴区溃疡均在治疗后 2～ 4周内迅速愈合 ;术后两周复查彩超 ,大隐静脉主干完全闭塞。平均住院日 6( 3～ 1 5 ) d。结论 :静脉腔内激光联合戴戒术治疗下肢深静脉瓣膜功能不全 ,近期疗效可靠、创伤小、瘢痕少操作简便、安全 ,远期疗效有待进一步观察

The treatment of lower extremities deep vein dysfunction by endovenous laser combined with external banding valvuloplasty

Objective:To evaluate the value of endovenous treatment of superficial varicosities in lower extremities with DIOMED laser. Methods:24 patients (18 males and 6 females) with 35 lower limbs were treated by laser therapy combined with external banding valvuloplasty operation. 810-nm diode laser energy was delivered percutaneously into the GSV via a 600- micro m fiber. Three therapeutic entities were included: ①simple endovenous laser therapy, 5 limbs in 5 patients; ②endovenous laser therapy combined with external banding valvuloplasty of superficial femoral vein, 26 limbs in 20 patients;③endovenous laser therapy combined with ligation of perforator veins, 4 limbs in 4 patients. Patients were evaluated clinically and with duplex US at 1 week, 1 month, 3 months, 6 months, 1 year, and yearly thereafter to assess treatment efficacy and adverse reactions. Results:Successful occlusion of the GSV, defined as absence of flow on color Doppler imaging, was noted in 33 of 35 GSVs (94.3%) after initial treatment. Bruising was noted in 24% of patients and tightness along the course of the treated vein was present in 90% of limbs. There have been no skin burns, or cases of deep vein thrombosis. Conclusion:Endovenous laser appears to offer Mini-invasion treatment with lower rates of complication. It can be used in combination with surgery as well.