CAJ | 학술논문

目的评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效.方法 150例下肢静脉功能不全患者(150条患肢)随机分为A、B两组,每组75例.A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术,B组行大隐静脉高位结扎抽剥术联合曲张浅静脉TriVex刨吸术.比较两组的手术时间、术后首次下床时间、术后48 h的疼痛视觉模拟评分(VAPS)值、术后住院天数、皮下血肿和皮下硬结的发生情况;比较患者对手术的自身评价、手术前后美国静脉联盟CEAP分级、临床严重程度计分(VCSS)、慢性静脉功能不全问卷(CIVIQ)生活质量评分的变化.结果两组手术时间差异不显著,A组术后疼痛轻、下床时间早、住院天数少、皮下血肿发生率低,但皮下硬结发生率高于B组;术后4周对手术的评价A组优于B组;A、B手术前后CEAP分级、VCSS、CIVIQ评分变化差别有统计学意义(P<0.05),两组间VCSS分差、CIVIQ评分差异无统计学意义(P>0.05).结论利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效,且微创、并发症少、更具人性化;CEAP临床分级、VCSS临床计分和CIVIQ生活质量评分可用于评价其疗效.
목적 평개강내사빈폐합술연합TriVex포흡술치료하지정맥공능불전적료효.방법 150례하지정맥공능불전환자(150조환지)수궤분위A、B량조,매조75례.A조행대은정맥사빈폐합술연합곡장천정맥TriVex포흡술,B조행대은정맥고위결찰추박술연합곡장천정맥TriVex포흡술.비교량조적수술시간、술후수차하상시간、술후48 h적동통시각모의평분(VAPS)치、술후주원천수、피하혈종화피하경결적발생정황;비교환자대수술적자신평개、수술전후미국정맥련맹CEAP분급、림상엄중정도계분(VCSS)、만성정맥공능불전문권(CIVIQ)생활질량평분적변화.결과 량조수술시간차이불현저,A조술후동통경、하상시간조、주원천수소、피하혈종발생솔저,단피하경결발생솔고우B조;술후4주대수술적평개A조우우B조;A、B수술전후CEAP분급、VCSS、CIVIQ평분변화차별유통계학의의(P<0.05),량조간VCSS분차、CIVIQ평분차이무통계학의의(P>0.05).결론 이용사빈폐합술연합TriVex포흡술치료하지정맥공능불전유효,차미창、병발증소、경구인성화;CEAP림상분급、VCSS림상계분화CIVIQ생활질량평분가용우평개기료효.
Objective To evaluate therapeutic results of endovenous radiofrequency in combination with TriVex in treatment of venous insufficiency in lower extremities.Methods One hundred and fifty patients with chronic venous insufficiency (150 limbs) were randomly assigned to Group A (75 limbs) and Group B (75 limbs).Patients in Group A were treated with long saphenous veins radiofrequency ablation procedures in combination with TriVex.Patients in Group B were treated with long saphenous veins traditional stripping operation in combination with TriVex.The postoperative pain,average hospital stay and short-term results in hospital were compared between the two groups.Self-assessment of the operation 4 weeks after,changes of CEAP classification,venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ) score were compared between the two groups.Results The operation time in Group A was (67±11) min,compared with (59±9) min in Group B (P>0.05).Postoperative pain and average hospital stay in Group A were significantly lower than those in Group B (P<0.05).The scores of self-assessment of the operation in Group A was higher than that in Group B 4 weeks after operation(P<0.05).The change of CEAP classification,VCSS and quality of life were significant after operation in both groups.The VCSS of Group A decreased by 4.6±2.5 compared with 4.3±2.7 in Group B (P>0.05).Conclusions Endovenous radiofrequency combined with TriVex for treatment of venous insufficiency in lower extremity is available,effective and with less trauma and faster recovery.CEAP classification,VCSS and CIVIQ are useful tools for assessing outcomes after radiofrequency in these patients.