下肢静脉曲张激光闭合术与剥脱术的近期疗效对比研究

目的:对比研究大隐静脉激光闭合术和高位结扎 分段剥脱术的近期疗效.方法:60例(70条肢体)下肢静脉曲张患者随机分为两组,每组30例,激光组先高位结扎大隐静脉主干,然后利用激光能量全程闭合主干及小腿曲张侧支;剥脱组采用传统手术方法(大隐静脉高位结扎 分段剥脱术).比较两组手术时间、术中出血量、术后住院天数、切口数及深静脉瓣膜功能变化等指标.结果:两组患者症状均明显改善,激光组术中出血量、切口数均显著低于剥脱组(P＜0.01),手术时间和术后住院天数两组无明显差异(P＞0.05);两组患者术后深静脉返流均明显减少(P＜0.01),激光组与剥脱组对深静脉返流的改善无差异(P＞0.05).结论:两种手术方法均是治疗下肢静脉曲张的有效术式,均可明显改善深静脉瓣膜功能,但激光闭合术体现了下肢静脉曲张的微创治疗,临床可根据患者的实际情况加以选择.

Comparison of Immediate Therapeutic Effects of Endovenous Laser Treatment and Stripping for Lower Extremity Variose Veins

Objective: Comparison of immediate therapeutic effects of endovenous laser treatment and proximal saphenous vein ligation and ablation of varicose veins for lower extremity varicose veins.Methods:60(70 limbs)patients with Varicose veins of lower extremity were randomized into two groups respectively according to the operating style.The laser group was given proxinal saphenous vein ligation before the wall of greater saphenous vein was treated with power of laser,to occlude the whole length of the vein and other collaterals;the stripping group was given poximal saphenous vein ligation and ablation of varicose veins.Operation and hospitalization time,blood losing,number of the incision,changes of deep venous valve function were compared.Results:The agonies of the patients were alleviated in both the two groups.In the laser group,blood losing and number of the incision were greatly less than the stripping group(P<0.01),but the operation and hospitalization time have no significant difference between the two surgical methods(P>0.05).The time of deep venous reflux was shortened significantly in both the two groups(P<0.01),but the improvement of deep venous hemodynaics has no significant difference between the two surgical methods(P>0.05).Conclusion:Both surgical methods are effective for Varicose veins of lower extremity,and it is confirmed that they can improve deep vein valve function,while the endovenous laser treatment is a more minimally invasive method in the treatment of lower extremity varicose veins.Surgeons can choose either one according to the patient's instance.