大隐静脉高位结扎并腔内激光闭合术治疗下肢浅静脉曲张

[摘要] 目的 评价应用大隐静脉高位结扎并腔内激光闭合术治疗下肢浅静脉曲张的临床疗效。方法 对110例（共146条肢体）下肢浅静脉曲张患者采用大隐静脉高位结扎+属支离断并腔内激光闭合术，若合并有静脉石或血栓性浅静脉炎的部位，则手术切除曲张的静脉团；术后随访疗效，包括观察分析术后的近期和远期并发症。结果 随访95例131条肢体，平均随访（10±5）个月；绝大部分患者取得了满意的临床疗效，曲张静脉团块消失，患肢酸胀不适感消失，满意率达96.9%；部分患者在术后一段时间内存在并发症，如患肢肿胀，皮肤灼伤，有压痛的条索或硬结，皮下淋巴感染，皮肤麻木，给予对症处理后症状均得到缓解；1条肢体并发深静脉血栓；另有3条肢体曲张静脉局部复发。结论 大隐静脉高位结扎+属支离断并腔内激光闭合术治疗下肢浅静脉曲张疗效可靠。对合并有静脉石或血栓性浅静脉炎的部位，应手术切除曲张的静脉团；激光治疗规范化操作能有效减少并发症。

High ligation of great saphenous vein combined with endovenous laser treatment for varicose veins in lower extremities.

Objective to evaluate the clinical efficacy of high ligation of great saphenous vein combined with endovenous laser treatment for varicose veins in lower extremities.Methods 110 cases (A total of 146 limbs) of varicose veins in lower extremities were treated by high ligation of great saphenous vein and affiliated branches amputation combined with endovenous laser treatment, the site combined with thrombophlebitis or phlebolith ,then exairesis of varicose vein group, and followed-up therapeutic effect, including observing and analyzing the short-term and long-term postoperative complications. Results Followed-up of 95 cases (A total of 131 limbs ), the average was 10±5 months; most of the patients were satisfied with results. varicose veins group and the discomfort of limb disappeared, satisfaction up to 96.9%. Some patients had complications in a period of time after surgery, such as limb swelled, skin burned, painful induration or trabs, infection of subcutaneous lymphatic tissue and skin numbness.These symptoms could be released after correctly treatment. 1 limbs complicated by deep venous thrombosis, another 3 limbs varicose vein to recur. Conclusions High ligation of great saphenous vein and affiliated branches amputation combined with endovenous laser treatment of varicose veins in lower extremities is effective and reliable. The varicose veins combined with thrombophlebitis or phlebolith should be removed. Standard operations of laser could be effective in reducing the complications.