| 刘永昌.腔内射频消融术与高位结扎抽剥术治疗大隐静脉曲张疗效对比分析[J].浙江中西医结合杂志,2022,32(10): |
| 腔内射频消融术与高位结扎抽剥术治疗大隐静脉曲张疗效对比分析 |
| Comparative analysis of radiofrequency ablation and high ligation and stripping in the treatment of varicose veins of lower limbs |
| 投稿时间：2022-06-18 修订日期：2022-08-01 |
| DOI： |
| 中文关键词: 腔内射频消融术 高位结扎抽剥术 大隐静脉曲张 |
| 英文关键词:radiofrequency ablation, high ligation and stripping, varicose vein |
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| 中文摘要: |
| 目的 探讨腔内射频消融术（RFA)和高位结扎抽剥术（HLS）治疗大隐静脉曲张的临床效果对比。方法 采用回顾性病例对照研究分析杭州市第一人民医院血管外科病房于2018 年1月至2020年12月，收住入院的560例原发性大隐静脉曲张病人,观察组共纳入280例（330条腿）行腔内射频消融术治疗的患者,同期280例(335条腿)接受高位结扎抽剥术治疗的患者作为对照组。两组治疗均联合点式抽剥和静脉注射泡沫硬化剂。比较两组手术所需时间、手术过程中出血量、手术结束后住院的时长、疼痛视觉模拟评分(VAS) 、手术之后并发症发生的比率（大腿血肿、切口感染、深静脉血栓形成、隐神经损伤），并比较两组术后1周、1月、1年临床—病因—解剖—病理生理(CEAP)分期、静脉临床严重程度评分(VCSS)、阿伯丁静脉曲张问卷评分(AVVSS)及下肢静脉曲张复发率。结果 观察组的手术所需的时间、手术过程中的出血总量、手术结束后总的住院时长、疼痛视觉模拟评分(VAS)、并发症发生的比率（大腿血肿、切口感染、深静脉血栓形成、隐神经损伤）均低于对照组；随访1年观察组CEAP分级优于对照组，差异有统计学意义(均P<0.05)；术后1年，观察组和对照组VCSS评分及AVVSS评分均较术前改善(均P<0.05)；对照组在术后1年再通率方面高于观察组，两组在复发率无统计学意义（P>0.05）结论 腔内射频消融术与高位结扎抽剥术相比，已经成为一种同样有效和安全的治疗方法，可降低围手术期和术后并发症发生率，提高患者满意度，值得在临床治疗中推广。 |
| 英文摘要: |
| Objective To compare the clinical result of high ligation and stripping (HLS) and radiofrequency ablation (RFA) in the therapy of varicose veins of lower limbs. Methods A retrospective case-control study was conducted in 560 patients with primary varicose veins of lower limbs in Hangzhou First People's Hospital from January 2018 to December 2020, of them 280 patients (330 limbs) in RFA as observation group and other 280 patients (335 limbs) in HLS as control group. Both groups were treated with point stripping and foam sclerotherapy. CEAP classification and venous clinical severity score (VCSS) and Aberdeen Varicose Vein Symptom Severity (AVVSS) scores of patients were assessed pre- and postoperatively to evaluate clinical outcome and quality of life. Results The operative time, intraoperative blood loss, postoperative hospital stays, visual analogue scale (VAS) and postoperative complication rate (thigh hematoma, incision infection, deep vein thrombosis, saphenous nerve injury) in the observation group were lower than those in the control group. In CEAP grading, the observation group was superior to the control group, after 1-year follow-up, and the statistical results were statistically significant; One year after surgery, VCSS and AVVSS score of observation and control group were improved compared with that before operation (P<0.05); One year after surgery, The recanalization rate of great saphenous vein in RFA was lower than that in HLS but there was no significant difference in the recurrence rate of great saphenous vein between the two groups (P> 0.05). Conclusion The RFA technique, Compared with HLS, that we have explored in our study is an effective and safe treatment that provides lower complication rates and increases patient satisfaction during the peri- and postoperative periods. Therefore, it is worth promoting in clinical treatment. |
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