血管内激光闭塞术与短剥术治疗静脉曲张的近期疗效比较分析

中国激光医学杂志 Pub Date : 2021-11-27 DOI:10.37895/2071-8004-2021-25-2-55-62

Петровского, Россия, Минздрава России, Сеченовский Университет, Москва, Сеть клиник, Ви Терра

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引用次数: 0

摘要

本研究的目的是通过分析超声表现、术后并发症、术后疼痛程度、临床表现和干预后康复时间，比较短剥离术(SS)和静脉内激光闭塞术(EVLO)治疗静脉曲张患者的结果(6个月内)。下肢静脉曲张和大隐静脉瓣膜功能不全的患者行EVLO或SS合并小静脉切除术。所有患者均于术前、术后5天、10天、1、3、6个月进行检查。同时进行临床检查，超声双工扫描下肢静脉;静脉临床严重程度评分(VCSS)也用于试验。在手术后的前10天使用10分疼痛评估量表评估疼痛。156例患者(177条下肢)随访6个月。我们的研究结果显示，静脉内激光闭塞术和短剥离术在消除大隐静脉返流方面同样有效。随访6个月后，SS组1例出现沿内侧流的反流;EVLO组在3个月内发现1例GSV部分再通，在6个月内发现3例。此外，尽管给予LMH预防剂量，EVLO组仍有1例患者发生EHIT II型深静脉血栓形成。所得结果表明，EVLO和SS具有相似的有效性和安全性。除SS组术后疼痛和瘀伤更明显外，两种治疗方法无明显差异。在消除GSV反流、缓解症状和消除静脉曲张以及改善生活质量方面，所进行的护理同样安全有效。长期结果，特别是取决于干预类型的复发率，将在未来的试验中进行研究。

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Comparative analysis of short-term outcomes after surgical treatment of varicose disease with endovasal laser obliteration and short stripping

The purpose of this study was to compare outcomes (within six months) after short stripping (SS) and endovenous laser obliteration (EVLO) in patients with varicose veins when analyzing ultrasound findings, postoperative complications, level of postoperative pain, clinical manifestations, and duration of rehabilitation after the intervention. Patients with varicose veins of lower extremities and insufficiency of large saphenous vein valves had either EVLO or SS with miniflebectomy. All patients were examined before surgery and then in 5 days, 10 days and in 1, 3 and 6 months after it. The patients also had clinical examination, ultrasound duplex scanning of their lower extremity veins; Venous Clinical Severity Score (VCSS) was also used for the trial. Pain was assessed during the first 10 days after the surgery using a 10-point pain assessment scale. 156 patients (177 lower extremities) were followed-up for 6 months. As the results of our study showed, endovenous laser obliteration and short stripping were equally effective in eliminating the reflux of the great saphenous vein (GSV). After 6 months of follow-up, the reflux along the medial inflow was noted in one case in SS group; partial GSV recanalization was noted in one case in EVLO group in 3 months, in 3 cases – in 6 months. Besides, despite LMH preventive doses one patient from EVLO group had EHIT II deep vein thrombosis. The obtained outcomes have demonstrated that EVLO and SS have similar effectiveness and safety. No difference has been found between these two types of treatment, except more pronounced postoperative pain and bruising in SS group. Performed care was equally safe and effective in eliminating GSV reflux, in relieving symptoms and eliminating varicose veins as well as in improving the quality of life. Long-term outcomes, especially the rate of relapses depending on the type of intervention, are to be investigated in future trials.

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来源期刊

中国激光医学杂志

自引率

0.00%

发文量

5650

期刊介绍： The main columns of "Chinese Journal of Laser Medicine & Surgery" include treatises, which report the latest research results in basic research and clinical trials in the field of laser medicine; comprehensive reviews of the latest research progress in laser medicine at home and abroad. In addition, there are short reports and excerpts from foreign journals, conference news and other columns. The journal has published a large number of papers on basic research on laser medicine and applied research in various clinical subjects, aiming to play a positive role in promoting the application of laser in medicine and improving the level of laser medicine research.