[1]崔智淼 陈占 刘军 林瑞敏* 李天润①.超声引导射频消融联合泡沫硬化剂注射治疗原发性小隐静脉曲张[J].中国微创外科杂志,2024,01(10):657-661.
　Cui Zhimiao,Chen Zhan,Liu Jun,et al.Ultrasoundguided Radiofrequency Ablation Combined With Injection of Foam Sclerosing in the Treatment of Primary Small Saphenous Vein Varicosities[J].Chinese Journal of Minimally Invasive Surgery,2024,01(10):657-661.
点击复制

超声引导射频消融联合泡沫硬化剂注射治疗原发性小隐静脉曲张()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年10期
页码:
657-661
栏目:
临床研究
出版日期:
2024-10-25

文章信息/Info

Title:
Ultrasoundguided Radiofrequency Ablation Combined With Injection of Foam Sclerosing in the Treatment of Primary Small Saphenous Vein Varicosities
作者:
崔智淼 陈占 刘军 林瑞敏* 李天润①
(北京市海淀医院血管外科，北京100080)
Author(s):
Cui Zhimiao;  Chen Zhan;  Liu Jun;  et al.
Department of Vascular Surgery, Beijing Haidian Hospital, Beijing 100080, China
关键词:
小隐静脉曲张; 射频消融; 泡沫硬化治疗
Keywords:
Small saphenous vein varicosities; Radiofrequency ablation; Foam sclerotherapy
文献标志码:
A
摘要:
目的探讨超声引导射频消融联合泡沫硬化剂注射治疗原发性小隐静脉曲张的有效性和安全性。方法对2021年11月~2022年11月我科46例原发性小隐静脉曲张进行回顾性分析，由患者选择手术方式，行射频消融联合硬化剂注射(观察组)和小隐静脉高位结扎剥脱(对照组)各23例。比较2组手术时间、术中出血量、住院时间、静脉临床严重程度评分(Venous Clinical Severity Score，VCSS)、并发症、治疗满意度和复发情况。结果与对照组相比，观察组手术时间短［(561±60)min vs(817±106)min，t=-10128，P=0000］，出血量少［(270±41)ml vs(414±48)ml，t=-11016，P=0000］，住院时间短［(20±07)d vs(56±09)d，t=-14319，P=0000］，术后3、6、12个月VCSS评分低［(74±20)分vs(89±25)分，t=-2165，P=0036；(53±18)分vs(65±22)分，t=-2149，P=0037；(26±13)分vs(40±18)分，t=-2912，P=0006］，满意度高(满意、基本满意、不满意观察组为18、4、1例，对照组为8、10、5例，Z=-2967，P=0003)。2组术后并发症发生率及术后12个月复发率差异均无统计学意义(P>005)。结论超声引导射频消融联合泡沫硬化剂注射治疗原发性小隐静脉曲张是安全、有效的。
Abstract:
ObjectiveTo explore the efficacy and safety of ultrasoundguided radiofrequency ablation combined with foam sclerotherapy in the treatment of primary small saphenous vein varicosities. MethodsA total of 46 patients with primary small saphenous vein varicosities in our department from November 2021 to November 2022 were retrospectively analyzed. Depending on the patient’s choice of surgical method, they underwent radiofrequency ablation combined with sclerotherapy (observation group, n=23) or high ligation and stripping of the saphenous vein (control group, n=23). The surgical time, intraoperative blood loss, length of hospital stay, postoperative Venous Clinical Severity Score (VCSS), incidence of postoperative complications, treatment satisfaction, and recurrence were compared between the two groups.ResultsCompared with the control group, the observation group had shorter surgical time ［(56.1±6.0) min vs. (81.7±10.6) min, t=-10.128, P=0.000］, less intraoperative blood loss ［(27.0±4.1) ml vs. (41.4±4.8) ml, t=-11.016, P=0.000］, shorter hospitalization time ［(2.0±0.7) d vs. (5.6±0.9) d, t=-14.319, P=0.000］, lower VCSS scores at 3, 6, and 12 months after surgery ［(7.4±2.0) points vs. (8.9±2.5) points, t=-2.165, P=0.036; (5.3±1.8) points vs. (6.5±2.2) points, t=-2.149, P=0.037; (2.6±1.3) points vs. (4.0±1.8) points, t=-2.912, P=0.006］, higher satisfaction ［satisfied, somewhat satisfied, dissatisfied in 18, 4, and 1 cases in the observation group and 8, 10, and 5 cases in the control group, respectively, Z=-2.967, P=0.003］. There were no statistically significant differences in the complication incidence and recurrence rate between the two groups (P>0.05).ConclusionUltrasoundguided radiofrequency ablation combined with foam sclerotherapy in the treatment of primary small saphenous vein varicosities is safe and effective.

参考文献/References:

[1]汪佳旭,张巍,韩天,等.超声引导射频消融治疗下肢静脉功能不全的疗效及预后影响因素分析.临床超声医学杂志,2021,23(5):342-346.
[2]Jia W,Liu J,Cheng Z.Clinical efficacy of endovenous radiofrequency ablation (RFA) for superficial varicose veins of the lower extremities.Dis Markers,2022,2022:1673588.
[3]Tan J,Chen Y,Huang J,et al.A systematic review of endovenous ablation for the treatment of small saphenous varicose veins.Vasa,2023,52(6):355-365.
[4]中华医学会外科学分会血管外科学组,中国医师协会血管外科医师分会,中国医疗保健国际交流促进会血管外科分会,等.中国慢性静脉疾病诊断与治疗指南.中华医学杂志,2019,99(39):3047-3061.5中国微循环学会周围血管疾病专业委员会.原发性下肢浅静脉曲张诊治专家共识(2021版).血管与腔内血管外科杂志,2021,7(7):762-772.
[6]Brake M,Lim CS,Shepherd AC,et al.Pathogenesis and etiology of recurrent varicose veins.J Vasc Surg,2013,57(3):860-868.
[7]周海华,马增辉,万伯顺,等.腔内激光闭合术与传统剥脱手术治疗小隐静脉曲张的对比研究.中国临床医学,2019,26(3):467-470.
[8]李井荣,荣智华,张望德,等.超声引导下射频消融联合点式剥脱术及泡沫硬化剂对原发性小隐静脉曲张的治疗效果.血管与腔内血管外科杂志,2023,9(6):641-644,653.
[9]Boersma D,Kornmann VN,van Eekeren RR,et al.Treatment modalities for small saphenous vein insufficiency:systematic review and metaanalysis.J Endovasc Ther,2016,23(1):199-211.
[10]Gonalves Pereira R,Tiago J,Cabral G,et al.Recurrent varicose veins following small saphenous vein surgery:a 5year followup duplex ultrasound study.Port J Card Thorac Vasc Surg,2021,28(3):39-46.
[11]闫昌葆,刘大方,张杰,等.可塑形射频导管在迂曲大隐静脉射频治疗中的应用.中国微创外科杂志,2023,23(2):153-157.
[12]Oki A,Muji H,Hadimehmedagi A,et al.The level of occlusion of small saphenous vein after endovenous laser ablation.Med Glas (Zenica),2024,21(1):147-153.
[13]Apruzzi L,Bilman V,Ardita V,et al.Comparison of mechanochemical ablation versus ligation and stripping for the treatment of incompetent small saphenous vein.Phlebology,2022,37(1):48-54.
[14]Pavei P,Spreafico G,Bernardi E,et al.Favorable longterm results of endovenous laser ablation of great and small saphenous vein incompetence with a 1470nm laser and radial fiber.J Vasc Surg Venous Lymphat Disord,2021,9(2):352-360.
[15]Mura S,De Biasio F,Zingaretti N,et al.Common peroneal nerve injury related to small saphenous vein surgery: report of 2 cases and review of the literature.Case Rep Neurol,2021,13(1):24-30.
[16]Baccellieri D,Apruzzi L,Ardita V,et al.Early results of mechanochemical ablation for small saphenous vein incompetency using 2% polidocanol.J Vasc Surg Venous Lymphat Disord,2021,9(3):683-690.
[17]雷章成,王刚.泡沫硬化剂治疗下肢静脉曲张的临床研究进展.黑龙江医学,2023,47(8):1012-1015,1019.
[18]林万里,吴忠寅,丁锐.聚多卡醇泡沫硬化剂治疗术与腔内激光闭合术对下肢浅静脉曲张的疗效.血管与腔内血管外科杂志,2023,9(4):416-420.
[19]Shi X,Liu Y,Li D,et al.The stability of physiciancompounded foam is influenced by the angle of connector.Ann Vasc Surg,2024,99:217-222.
[20]Danneil O,Dorler M,Stockfleth E,et al.Factors influencing superficial and deep vein thrombosis after foam sclerotherapy in varicose veins.J Dtsch Dermatol Ges,2022,20(7):929-938.

备注/Memo

备注/Memo:
*通讯作者，Email：linmihu@sina.com ①(北京大学第三医院介入血管外科，北京100191)
更新日期/Last Update: 2024-12-30