CAJ | 학술논문

目的：探讨内压迫改良内翻抽剥术治疗大隐静脉(GSV)曲张的效果、可行性及应用价值。方法选择2011年6月~2013年1月温州医科大学附属第三医院收治的单纯性GSV曲张患者230例，随机分为观察组(115例)和对照组(115例)。观察组采用内压迫改良内翻抽剥+点状抽剥术；对照组采用传统大隐静脉内翻剥脱+点状抽剥术。观察GSV一次抽剥成功率、手术时间、术中出血量、首次下床活动时间、术后皮下出血、术后VAS疼痛评分、深静脉血栓形成、隐神经损伤、复发率情况。结果观察组GSV一次抽剥成功率高于对照组(P<0.01)，手术时间、首次下床活动时间明显短于对照组(P<0.01)，术中失血量、术后皮下出血明显少于对照组(P<0.01)，术后VAS疼痛评分低于对照组(P<0.01)。两组深静脉血栓形成、隐神经损伤、复发率等术后并发症比较差异无统计学意义(P>0.05)。结论内压迫改良内翻抽剥术治疗GSV曲张临床优势明显，值得临床应用推广。
목적：탐토내압박개량내번추박술치료대은정맥(GSV)곡장적효과、가행성급응용개치。방법선택2011년6월~2013년1월온주의과대학부속제삼의원수치적단순성GSV곡장환자230례，수궤분위관찰조(115례)화대조조(115례)。관찰조채용내압박개량내번추박+점상추박술；대조조채용전통대은정맥내번박탈+점상추박술。관찰GSV일차추박성공솔、수술시간、술중출혈량、수차하상활동시간、술후피하출혈、술후VAS동통평분、심정맥혈전형성、은신경손상、복발솔정황。결과관찰조GSV일차추박성공솔고우대조조(P<0.01)，수술시간、수차하상활동시간명현단우대조조(P<0.01)，술중실혈량、술후피하출혈명현소우대조조(P<0.01)，술후VAS동통평분저우대조조(P<0.01)。량조심정맥혈전형성、은신경손상、복발솔등술후병발증비교차이무통계학의의(P>0.05)。결론내압박개량내번추박술치료GSV곡장림상우세명현，치득림상응용추엄。
Objective To explore the effect, feasibility and application value of modified invaginated stripping with compression inside in the treatment of great saphenous vein (GSV) varicosity. Methods 230 cases with primary GSV varicosity treated in the Third Affiliated Hospital of Wenzhou Medical University from June 2011 to January 2013 were recruited and randomly divided into the observation group (n=115) and the control group (n=115). The observation group was treated with the modified invaginated stripping with compression inside combined with pointed phlebectomy. The control group was treated with conventional invaginated stripping combined with pointed phlebectomy. One time success rate of GSV stripping, operating time, amount of bleeding during operation, first ambulation time, subcutaneous hemorrhage after operation, postoperative VAS pain score, deep venous thrombosis, saphenous nerve injury and recur-rence rate were assessed. Results Compared with the control group, the observation group had a higher one time suc-cess rate of GSV stripping (P<0.01), shorter operating time and earlier first ambulation time (P<0.01), less amount of bleeding during operation and subcutaneous hemorrhage after operation (P< 0.01), and lower postoperative VAS pain score (P<0.01). The deep venous thrombosis, saphenous nerve injury and recurrence rate between the two groups had no significant differences (P> 0.05). Conclusion The modified invaginated stripping with compression inside therapy for GSV varicosity has better clinical effects. It is worthy of clinical promotion.