中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
28期
64-66,67
,共4页
下肢浅静脉曲张%微小切口点状抽剥%驱血
下肢淺靜脈麯張%微小切口點狀抽剝%驅血
하지천정맥곡장%미소절구점상추박%구혈
Lower extremity varicose%Minimally invasive incision%Exsanguination
目的：探讨微小切口点状抽剥联合驱血带在下肢静脉曲张抽术中的应用效果。方法：选取2012年4月-2014年7月在本院应用微小切口点状抽剥联合驱血带治疗下肢浅静脉曲张87例患者（91条肢体）作为A组，另选取使用传统曲张静脉节段切除的传统方法治疗的85例患者（88条肢体）作为B组，回顾性分析两组患者的临床资料。比较两组患者的手术时间、住院时间，观察术后皮下淤血、血肿、肢体麻木等情况。结果：A组的平均手术时间（68±14.5）min和平均住院时间（7.2±1.3）d均明显短于B组的（79±13.6）min和（8.9±1.1）d，差异均有统计学意义（P<0.05）。A组无肿胀不适，切口无淤血、血肿，无患肢麻木等并发症。B组中3例患者出现淋巴漏，1例淋巴感染，2例患者小腿切口轻度水肿，13例患者小腿切口淤血、血肿，3例患肢足靴区麻木。术后随访6~24个月，A组效果良好，未见明显瘢痕，复发患者2例。B组小腿淤血、肿胀，在1~2月内消退，3例下肢麻木患者，其中2例缓解，1例未见明显缓解，3例复发。所有患者小腿可见多出明显手术瘢痕。结论：微小切口点状抽剥能够减少创伤面积，降低皮肤感觉障碍，抽剥彻底，术后复发率低；驱血可创造无血手术野，缩短手术时间，为彻底抽剥曲张静脉创造条件。微小切口点状抽剥脱联合驱血带在治疗下肢静脉曲张中是一种值得推广的简便、经济、实用的方案。
目的：探討微小切口點狀抽剝聯閤驅血帶在下肢靜脈麯張抽術中的應用效果。方法：選取2012年4月-2014年7月在本院應用微小切口點狀抽剝聯閤驅血帶治療下肢淺靜脈麯張87例患者（91條肢體）作為A組，另選取使用傳統麯張靜脈節段切除的傳統方法治療的85例患者（88條肢體）作為B組，迴顧性分析兩組患者的臨床資料。比較兩組患者的手術時間、住院時間，觀察術後皮下淤血、血腫、肢體痳木等情況。結果：A組的平均手術時間（68±14.5）min和平均住院時間（7.2±1.3）d均明顯短于B組的（79±13.6）min和（8.9±1.1）d，差異均有統計學意義（P<0.05）。A組無腫脹不適，切口無淤血、血腫，無患肢痳木等併髮癥。B組中3例患者齣現淋巴漏，1例淋巴感染，2例患者小腿切口輕度水腫，13例患者小腿切口淤血、血腫，3例患肢足靴區痳木。術後隨訪6~24箇月，A組效果良好，未見明顯瘢痕，複髮患者2例。B組小腿淤血、腫脹，在1~2月內消退，3例下肢痳木患者，其中2例緩解，1例未見明顯緩解，3例複髮。所有患者小腿可見多齣明顯手術瘢痕。結論：微小切口點狀抽剝能夠減少創傷麵積，降低皮膚感覺障礙，抽剝徹底，術後複髮率低；驅血可創造無血手術野，縮短手術時間，為徹底抽剝麯張靜脈創造條件。微小切口點狀抽剝脫聯閤驅血帶在治療下肢靜脈麯張中是一種值得推廣的簡便、經濟、實用的方案。
목적：탐토미소절구점상추박연합구혈대재하지정맥곡장추술중적응용효과。방법：선취2012년4월-2014년7월재본원응용미소절구점상추박연합구혈대치료하지천정맥곡장87례환자（91조지체）작위A조，령선취사용전통곡장정맥절단절제적전통방법치료적85례환자（88조지체）작위B조，회고성분석량조환자적림상자료。비교량조환자적수술시간、주원시간，관찰술후피하어혈、혈종、지체마목등정황。결과：A조적평균수술시간（68±14.5）min화평균주원시간（7.2±1.3）d균명현단우B조적（79±13.6）min화（8.9±1.1）d，차이균유통계학의의（P<0.05）。A조무종창불괄，절구무어혈、혈종，무환지마목등병발증。B조중3례환자출현림파루，1례림파감염，2례환자소퇴절구경도수종，13례환자소퇴절구어혈、혈종，3례환지족화구마목。술후수방6~24개월，A조효과량호，미견명현반흔，복발환자2례。B조소퇴어혈、종창，재1~2월내소퇴，3례하지마목환자，기중2례완해，1례미견명현완해，3례복발。소유환자소퇴가견다출명현수술반흔。결론：미소절구점상추박능구감소창상면적，강저피부감각장애，추박철저，술후복발솔저；구혈가창조무혈수술야，축단수술시간，위철저추박곡장정맥창조조건。미소절구점상추박탈연합구혈대재치료하지정맥곡장중시일충치득추엄적간편、경제、실용적방안。
Objective:To investigate the application effect of minimally incision punctate stripping combined with tourniquet in limb varicose vein stripping surgery.Method:87 patients(91 limbs)with lower limb varicose vein received the treatment of surgery by minimally incision punctate stripping combined with tourniquet in our hospital from April 2012 to July 2014 were selected as the group A,while 85 patients(88 limbs)received treatment of traditional surgery of segmental resection were selected as the group B.The clinical data of two groups were retrospectively analyzed. The operative time,hospital stay of the two groups were compared,postoperative subcutaneous congestion,hematoma, numbness in the two groups were observed.Result:the average of operative time was(68±14.5)min and average of hospital stay was(7.2±1.3)d in group A,they were significantly shorter than(79±13.6)min and(8.9±1.1)d in group B,the differences were statistically significant(P<0.05).In group A,without swelling,discomfort,congestion in the cut,hematoma and complications such as limb numbness.In group B,3 cases had lymphatic leakage,one case with lymphatic infection,two cases with mild edema of the leg incision,13 cases with hematoma,and 3 cases with limb numbness.All patients were followed up for 6-24 months.The efficacy of group A was good,with no obvious scars and relapse in 2 cases.In group B:calf congestion and swelling disappeared in 1-2 months;three cases had lower extremity numbness,including two cases of remission and one case of no obvious relief.Three cases recurred.All patients had visible surgical scars.Conclusion:Minimally incision punctate stripping can reduce the the skin numbness and the skin feeling obstacle,stripping completely,low recurrence rate after surgery,tourniquet can create a bloodless surgical field, shorten the operative time,create conditions for cleanly stripping varicose vein.Minimally incision punctate stripping combined with tourniquet in limb varicose vein stripping surgery is a simple,economic,practical scheme,is worthy of clinical promotion.
