CAJ | 학술논문

目的评价透视引导下聚桂醇泡沫硬化剂治疗下肢静脉性溃疡的疗效及安全性.方法搜集临床上有活动性溃疡症状和体征,彩色超声多普勒检查显示下肢浅表静脉有不同程度反流、曲张,深静脉通畅的26例下肢静脉性溃疡患者,共29条患肢.对曲张静脉进行选择性局部穿刺,透视引导下对大隐静脉、交通静脉及穿支静脉行聚桂醇泡沫硬化剂治疗.术后观察患者并发症和疗效.治疗后1周测量溃疡长径及短径,并采用配对t检验与治疗前溃疡径线比较.治疗后10个月对患肢疗效进行评估,并采用Wilcoxon符号秩检验与治疗前比较,采用Kaplan-Meier法分析治疗后溃疡的愈合时间.结果 26例患者的29条患肢均成功完成透视引导下聚桂醇泡沫硬化治疗.每条患肢泡沫硬化剂用量4.5～12.0 ml,平均(8.3±2.4) ml.26例均无严重并发症.治疗前溃疡长径和短径分别为(5.4±2.1)、(4.3±1.5) cm,治疗后1周分别为(2.8±2.0)、(2.1±1.6) cm,差异均有统计学意义(t值分别为8.971和9.053,P值均＜0.01).治疗前和治疗后10个月临床分级分别为4.0±0.0和2.5±0.7,差异有统计学意义(Z=-4.875,P＜0.01).溃疡愈合时间7.0～56.0d,平均(29.5±2.5)d.结论透视引导下聚桂醇泡沫硬化剂治疗下肢静脉溃疡安全有效.
목적 평개투시인도하취계순포말경화제치료하지정맥성궤양적료효급안전성.방법 수집림상상유활동성궤양증상화체정,채색초성다보륵검사현시하지천표정맥유불동정도반류、곡장,심정맥통창적26례하지정맥성궤양환자,공29조환지.대곡장정맥진행선택성국부천자,투시인도하대대은정맥、교통정맥급천지정맥행취계순포말경화제치료.술후관찰환자병발증화료효.치료후1주측량궤양장경급단경,병채용배대t검험여치료전궤양경선비교.치료후10개월대환지료효진행평고,병채용Wilcoxon부호질검험여치료전비교,채용Kaplan-Meier법분석치료후궤양적유합시간.결과 26례환자적29조환지균성공완성투시인도하취계순포말경화치료.매조환지포말경화제용량4.5～12.0 ml,평균(8.3±2.4) ml.26례균무엄중병발증.치료전궤양장경화단경분별위(5.4±2.1)、(4.3±1.5) cm,치료후1주분별위(2.8±2.0)、(2.1±1.6) cm,차이균유통계학의의(t치분별위8.971화9.053,P치균＜0.01).치료전화치료후10개월림상분급분별위4.0±0.0화2.5±0.7,차이유통계학의의(Z=-4.875,P＜0.01).궤양유합시간7.0～56.0d,평균(29.5±2.5)d.결론 투시인도하취계순포말경화제치료하지정맥궤양안전유효.
Objective To assess the efficacy and safety of foam sclerotherapy with lauromacrogol in the treatment of lower extremity varicose ulcer under fluoroscopic guidance.Methods Twenty sixpatients(29 legs) with lower extremity varicose ulcer,who had symptoms and signs of active ulcer,with different degrees of superficial vein reflux and varicosity of the lower extremity and deep vein patency evaluated by Doppler ultrasound,were collected.The selective paracentesis was used on varicose veins and fluoroscopic-guided foam sclerotherapy was performed on the great saphenous vein,communicating and perforating veins.The complication and efficacy were observed after treatment.The long and the short dimensions of the ulcer were measured at the first week after treatment and statistical comparison of the ulcerative meridian between pre-treatment and post-treatment was performed using the paired t test.The Wilcoxon signed rank test was used to compare the efficacy between the pre-treatment and the tenth month after the procedure.The ulcer-free time after treatment was calculated using Kaplan-Meier method.Result Twenty six patients(29 legs) were successfully treated by fluoroscopic guidance foam sclerotherapy,the average volume of foam sclerosing agent in each case was(8.3 ± 2.4) ml(4.5 to 12.0 ml).There was no severe complication among 26 cases.The long ulcer dimensions and the short ulcer dimensions were(5.4 ± 2.1) and (4.3 ± 1.5) cm before the treatment and(2.8±2.0) and(2.1 ± 1.6) cm in the first week after the procedure,respectively.The difference between them was significant(t values were 8.971 and 9.053,P＜0.01).The grading of the disease was 4.0 pre-treatment and 2.5±0.7 at the tenth month after the procedure,and showed significant statistical difference(Z=-4.875,P＜0.01).The ulcer healing time ranged from 7 to 56 days with mean healing time of(29.5 ± 2.5) days.Conclusion The use of fluoroscopic-guided injection of lauromacrogol foam to cure lower extremity varicose ulcer is safe and effective.