CAJ | 학술논문

目的探讨内窥镜血管取材系统在下肢静脉曲张治疗中作用及应用前景.方法回顾性2011年1月至2013年5月中日友好医院收治的41例下肢静脉曲张患者的临床资料,随机分为2组,内窥镜血管取材系统(endoscopic vessel harvesting,EVH)治疗组20例与对照组(传统手术组)21例.比较2组术后48 h和术后1周疼痛视觉模拟评分(visual analogue pain scale,VAPS),术后1周皮下淤血、血肿、皮肤麻木等症状,术后第3个月CEAP临床分级(clinical-etiology-anatomicpathophysiologic classification system,CEAP),手术效果及手术满意度评分情况. 结果术后48 h和术后1周VAPS评分,EVH组均低于对照组(P＜0.01).术后皮下瘀血发生率对照组高于EVH治疗组,但2组之间差异无统计学意义(P＞0.05).术后皮下血肿发生率、下肢麻木发生率对照组均明显高于EVH治疗组,差异有统计学意义(P＜0.01).2组患肢CEAP分级组间比较,差异无统计学意义(P＞0.05),但2组在手术前和手术后3个月CEAP分级的比较,均差异有统计学意义(P＜0.01).2组术后3个月手术效果评分,EVH组与对照组差异无统计学意义(P＞0.05).手术整体满意度评分,EVH组高于对照组,2组之间差异有统计学意义(P＜0.05).结论 EVH组与传统手术组在治疗静脉曲张时有同样的手术疗效,EVH是一种微创治疗静脉曲张的方法.
목적 탐토내규경혈관취재계통재하지정맥곡장치료중작용급응용전경.방법 회고성2011년1월지2013년5월중일우호의원수치적41례하지정맥곡장환자적림상자료,수궤분위2조,내규경혈관취재계통(endoscopic vessel harvesting,EVH)치료조20례여대조조(전통수술조)21례.비교2조술후48 h화술후1주동통시각모의평분(visual analogue pain scale,VAPS),술후1주피하어혈、혈종、피부마목등증상,술후제3개월CEAP림상분급(clinical-etiology-anatomicpathophysiologic classification system,CEAP),수술효과급수술만의도평분정황. 결과 술후48 h화술후1주VAPS평분,EVH조균저우대조조(P＜0.01).술후피하어혈발생솔대조조고우EVH치료조,단2조지간차이무통계학의의(P＞0.05).술후피하혈종발생솔、하지마목발생솔대조조균명현고우EVH치료조,차이유통계학의의(P＜0.01).2조환지CEAP분급조간비교,차이무통계학의의(P＞0.05),단2조재수술전화수술후3개월CEAP분급적비교,균차이유통계학의의(P＜0.01).2조술후3개월수술효과평분,EVH조여대조조차이무통계학의의(P＞0.05).수술정체만의도평분,EVH조고우대조조,2조지간차이유통계학의의(P＜0.05).결론 EVH조여전통수술조재치료정맥곡장시유동양적수술료효,EVH시일충미창치료정맥곡장적방법.
Objective To study the clinical outcome of endoscopic vessel harvesting system (EVH) for the treatment of lower limbs varicose veins.Methods Patients (n =41) with varicose veins admitted from Jan 2011 to May 2013 were randomly divided into EVH group (n =20) and stripping group (n =21).Indexes as postoperative VAPS (48 hours and 1 week),subcutaneous ecchymosis (1 week),hematoma(1 week),skin numbness (1 week),CEAP classification (3 months),surgery effect and satisfaction scores(3 months) were compared between the two groups.Results 48 hours and 1 week VAPS was lower in EVH group(P ＜0.01).After EVH there was less subcutaneous ecchymosis (1 week),hematoma(1 week) and skin numbness (1 week) (all P ＜ 0.01).Postoperative CEAP classification improved significantly in both groups (P ＜ 0.01),while surgery effect and satisfaction scores (3 months) were better in EVH group (P ＜ 0.05).Conclusions EVH is a safe and minimally invasive technique in treatment of varicose veins of the lower limbs.