CAJ | 학술논문

目的探讨选择性保留膝下大隐静脉(great saphenous veins,GSV)主干在预防静脉曲张手术中隐神经损伤的作用.方法本研究为单中心前瞻性随机对照研究.2009年1月至2012年1月连续治疗280例大隐静脉曲张患者,随机分为2组,每组140例,观察组剥脱大隐静脉主干至膝下水平,对照组剥脱大隐静脉主干至内踝水平.2组均结合透光旋切(transilluminated powered phlebectomy,TIPP)及泡沫硬化剂(foam sclerotherapy)治疗.主要观察指标为术后疼痛、隐神经缺失、症状改善情况及术后复发的发生率.结果术后随访1个月时,观察组有5.71％(8/140)出现神经系统症状,对照组有14.29％ (20/140),(P=0.02).术后随访12个月时,观察组有1.47％(2/136)主诉手术肢体感觉异常,对照组有7.14％(9/126),(P=0.02).结论选择性保留膝下大隐静脉主干可减少隐神经损伤的发生.
목적 탐토선택성보류슬하대은정맥(great saphenous veins,GSV)주간재예방정맥곡장수술중은신경손상적작용.방법 본연구위단중심전첨성수궤대조연구.2009년1월지2012년1월련속치료280례대은정맥곡장환자,수궤분위2조,매조140례,관찰조박탈대은정맥주간지슬하수평,대조조박탈대은정맥주간지내과수평.2조균결합투광선절(transilluminated powered phlebectomy,TIPP)급포말경화제(foam sclerotherapy)치료.주요관찰지표위술후동통、은신경결실、증상개선정황급술후복발적발생솔.결과 술후수방1개월시,관찰조유5.71％(8/140)출현신경계통증상,대조조유14.29％ (20/140),(P=0.02).술후수방12개월시,관찰조유1.47％(2/136)주소수술지체감각이상,대조조유7.14％(9/126),(P=0.02).결론 선택성보류슬하대은정맥주간가감소은신경손상적발생.
Objective To evaluate selective retention of the great saphenous vein (GSV) belowknee in the prevention of saphenous nerve injury during varicose veins surgery.Methods From January 2009 to January 2012,280 consecutive patients with incompetence of the GSV resulting in varicose veins were prospectively randomized into 2 groups.Patients in the experimental group underwent stripping restricted to the below knee level,patients in control group underwent GSV stripping to the ankle level Patients in the two groups were treated with transilluminated powered phlebectomy,and foam sclerotherapy.Primary end points were postoperative pain,saphenous nerve injury,quality of life and recurrence rate.Results After one month follow-up:5.71％ patients had symptoms of nervous system in the observation group,14.29％ patients had symptoms of nervous system in the control group (P =0.02).After 1 year follow-up,1.47％ patients had symptoms of nervous system in the observation group,7.14％ patients had symptoms of nervous system in the control group (P =0.02).Conclusions Selective retention of great saphenous vein below-knee decreases saphenous nerve injury.