中国血管外科杂志（电子版）
中國血管外科雜誌（電子版）
중국혈관외과잡지（전자판）
CHINESE JOURNAL OF VASCULAR SURGERY(ELECTRONIC VERSION)
2014年
3期
167-169
,共3页
静脉曲张%腔内激光%并发症%防治
靜脈麯張%腔內激光%併髮癥%防治
정맥곡장%강내격광%병발증%방치
Varicose veins%Endovenous laser treatment%Complication%Prevention
目的：总结静脉腔内激光（EVLT）联合传统手术治疗单纯下肢静脉曲张的体会。方法对2011年1月至2013年12月收治的478例（577条患肢）下肢静脉曲张患者行EVLT联合传统手术治疗。CEAP分级：C2级（68条）、C3级（179条）行大隐静脉高位结扎+主干EVLT+小腿曲张静脉EVLT；C4级（120条）、C5级（145条）、C6级（65条）行大隐静脉高位结扎剥脱术+小腿曲张静脉EVLT术。观察患者术后并发症发生率。结果术后有218条[218/577（37.8%）]肢体出现并发症，部分肢体可存在2种以上的并发症，其中皮下淤血、瘀斑、血肿发生率为33.4%（193/577）；不同程度的皮肤灼伤为6.4%（37/577）；皮肤感觉异常为13.9%（80/577），下肢深静脉血栓形成为0.3%（2/577）。以上并发症经过积极治疗后均明显好转。随访时间4~36个月，未见症状复发。结论EVLT联合传统手术治疗单纯下肢静脉曲张具有创伤小、恢复快、并发症少的微创优势，应针对病因病情，联合不同术式，规范化操作，可有效降低并发症的发生率。
目的：總結靜脈腔內激光（EVLT）聯閤傳統手術治療單純下肢靜脈麯張的體會。方法對2011年1月至2013年12月收治的478例（577條患肢）下肢靜脈麯張患者行EVLT聯閤傳統手術治療。CEAP分級：C2級（68條）、C3級（179條）行大隱靜脈高位結扎+主榦EVLT+小腿麯張靜脈EVLT；C4級（120條）、C5級（145條）、C6級（65條）行大隱靜脈高位結扎剝脫術+小腿麯張靜脈EVLT術。觀察患者術後併髮癥髮生率。結果術後有218條[218/577（37.8%）]肢體齣現併髮癥，部分肢體可存在2種以上的併髮癥，其中皮下淤血、瘀斑、血腫髮生率為33.4%（193/577）；不同程度的皮膚灼傷為6.4%（37/577）；皮膚感覺異常為13.9%（80/577），下肢深靜脈血栓形成為0.3%（2/577）。以上併髮癥經過積極治療後均明顯好轉。隨訪時間4~36箇月，未見癥狀複髮。結論EVLT聯閤傳統手術治療單純下肢靜脈麯張具有創傷小、恢複快、併髮癥少的微創優勢，應針對病因病情，聯閤不同術式，規範化操作，可有效降低併髮癥的髮生率。
목적：총결정맥강내격광（EVLT）연합전통수술치료단순하지정맥곡장적체회。방법대2011년1월지2013년12월수치적478례（577조환지）하지정맥곡장환자행EVLT연합전통수술치료。CEAP분급：C2급（68조）、C3급（179조）행대은정맥고위결찰+주간EVLT+소퇴곡장정맥EVLT；C4급（120조）、C5급（145조）、C6급（65조）행대은정맥고위결찰박탈술+소퇴곡장정맥EVLT술。관찰환자술후병발증발생솔。결과술후유218조[218/577（37.8%）]지체출현병발증，부분지체가존재2충이상적병발증，기중피하어혈、어반、혈종발생솔위33.4%（193/577）；불동정도적피부작상위6.4%（37/577）；피부감각이상위13.9%（80/577），하지심정맥혈전형성위0.3%（2/577）。이상병발증경과적겁치료후균명현호전。수방시간4~36개월，미견증상복발。결론EVLT연합전통수술치료단순하지정맥곡장구유창상소、회복쾌、병발증소적미창우세，응침대병인병정，연합불동술식，규범화조작，가유효강저병발증적발생솔。
Objective To introduce the experience of endovenous laser treatment (EVLT) combined with traditional surgery in the treatment of lower extremity varicose veins.Methods The clinical data of 478 patients (577 limbs) with varicose veins of lower extremity in our department between Jan. 2011 and Dec. 2013 were analyzed retrospectively. These patients were divided into two group according to CEAP classification:Group A, including Grade C2 (68 limbs) and Grade C3 (179 limbs), underwent high ligation of the great saphenous vein combined with EVLT of the trunk of great saphenous vein and crus varicosity;Group B, including Grade C4 (120 limbs), Grade C5 (145 limbs) and Grade C6 (65 limbs), received high ligation and stripping of the great saphenous vein combined with EVLT of crus varicosity. Then, the complications were analyzed.Results Complications occurred in 218 limbs (218/577, 37.8%). Some limbs presented more than two kinds of complications. Complications mainly included subcutaneous hematoma and ecchymosis(33.4%, 193/577), different degrees of skin burns (6.4%, 37/577), abnormal sensation of skin (13.9%, 80/577) and deep vein thrombosis (0.3%, 2/577). These complications improved after treatment. After a follow-up of 4~36 months, there was no recurrence.Conclusion EVLT combined with traditional surgery has the advantages of minimal trauma, quick recovery and less complications. To reduce complications, different surgical procedures should be combined and performed properly according to different diseases.
