经大隐静脉插管栓塞术治疗下肢静脉曲张的临床价值

目的评价X线监视下经导管注入无水乙醇治疗下肢静脉曲张的远期疗效及安全性。资料与方法对69例(78条患肢)下肢静脉曲张患者行穿刺或切开内踝上方大隐静脉插入导管,在X线及对比剂监视下注入无水乙醇栓塞治疗。结果 75条(96.%)患肢均一次性栓塞成功;75条患肢于术后7天～3个月多普勒超声显示栓塞的大隐静脉未探及血流信号。随访3～55个月(平均31.2个月),术后3～7天曲张的静脉均塌陷,2～3周临床症状明显减轻或消失,7条小腿溃疡于术后4～6周愈合。13例(18.8%)术后出现咳嗽、胸闷,5～10 min内消失;7条患肢(9.0%)术后肢体出现迟发性感觉异常,2～3周内恢复正常;31条(39.7%)患肢术后第2天出现轻度肿胀,1～2周内均消失;3条(3.8%)患肢于术后12个月内出现小腿浅静脉局限性轻度曲张,无1例深静脉血栓等严重并发症发生。结论经大隐静脉插管注入无水乙醇治疗下肢静脉曲张安全、并发症少,远期疗效肯定;有望成为下肢静脉曲张新的治疗方法之一。

Clinical Value of Transcatheter Infusion of Absolute Ethanol Embolism to Treat for Varicose Veins of Lower Extremity

Objective To explore the long term clinical efficacy and safety of transcathete infusion of absolute ethanol to treat on varicose veins of lower extremity under X-ray monitoring.Materials and Methods 78 patients with varicose veins of lower extremity and normal deep venous flow were recruited.We punctured or cut through great saphenous vein and insert catheter and injected the absolute ethenal under the monitor of X-ray and contractor.Results 75(96%)cases varicose veins of lower extremity were embolised successfully.No blood flow was seen in the 75 embolismic great saphenous vein after 7 day to 3 months monitoring with Doppler ultrasound.They were followed up for 3-55 months(average 31.2 months),varicose veins were collapsed after 3 to7 days.Clinical symptoms were alleviated obviously after 2-3 weeks of treatment.7 cases of leg ulceration were healed in 4 to 6 weeks after operation.13 cases(16.7%) had cough,dyspnea after operation,and the symptoms disappeared in 5-10 min.7 treated limbs(9.3%) developed delayed paresthesia after the surgery,and recovered after 2-3 weeks.31 limbs were found mild swelling in 2 days after the surgery.3 limbs(3.8%) appeared local slight swelling of superficial vein.No complications of deep vein thrombosis,were found after operation.Conclusion Using transcatheter injection of absolute ethanol to treat varicose veins of lower extremity has the advantage of cost efficiency,more safety and lower appearance of complications.The long term efficacy is solid and has the promise to be a new method for therapy of varicose veins of lower extremity.