经皮下连续环形缝扎术在下肢浅静脉曲张中的临床应用.docVIP

经皮下连续环形缝扎术在下肢浅静脉曲张中的临床应用 　　[摘要] 目的 评价经皮下连续环形缝扎术治疗下肢浅静脉曲张的方法及临床效果。 方法 回顾分析2009年6月～2012年12月136例大隐静脉曲张患者的临床资料，将其随机分为A、B组，A组70例行大隐静脉高位结扎剥脱术，B组66例行大隐静脉高位结扎剥脱、小腿部浅静脉行经皮下连续环形缝扎术，比较两组患者的临床效果。 结果 两组患者术后近期下肢浅静脉曲张均消失，两组患者的手术时间、切口数量、出血量、并发症比较，差异有统计学意义。 结论 经皮下连续环形缝扎术治疗下肢浅静脉曲张的操作简单、效果确切，且具有微创、外观美容的效果。 　　[关键词] 下肢；浅静脉曲张；皮下；续环形缝扎术 　　[中图分类号] R543 [文献标识码] A [文章编号] 1674-4721（2014）08（b）-0022-03 　　[Abstract] Objective To evaluate the method and clinical efficacy of percutaneous continuous circumsuture for treatment of superficial varicose veins of lower extremities. Methods A retrospective analysis was conducted on the clinical data of 136 cases of varicosis of great saphenous vein from Jun 2009 to Dec 2012，they were randomly assigned to group A and group B.Group A in 70 cases were given high ligation and exfoliation procedure on the great saphenous vein，group B in 66 cases were given high ligation and exfoliation procedure on the great saphenous vein and percutaneous continuous circumsuture on the calf superficial vein，the clinical effect of the two groups were compared. Results Superficial varicose veins of lower extremities disappeared in both groups after treatment.There had statistical difference of two groups in operation duration，incision number，blood loss and complications. Conclusion Percutaneous continuous circumsuture demonstrates easy operation，obvious efficacy，minimal invasiveness and cosmetic effect for treatment of superficial varicose veins of lower extremities. 　　[Key words] Lower extremities；Superficial varicose veins；Continuous circumsuture 　　下肢浅静脉曲张是外科常见病之一，常因长期站立、重体力劳动、妊娠、慢性咳嗽、习惯性便秘等诱发[1]。传统的下肢静脉曲张治疗是高位结扎、剥脱曲张的大隐静脉主干及曲张的属支、结扎功能不全的交通支静脉，效果肯定，但创伤大、切口与手术瘢痕多、皮肤易坏死和感染、欠美观。近几年来国内开展的大隐静脉腔内微创治疗，如激光治疗、射频消融、微波固化等，设备昂贵，费用较高。本院采用大隐静脉高位结扎抽剥加小腿部经皮下连续环形缝扎术治疗下肢浅静脉曲张，取得了较好的效果。 　　1 资料与方法 　　1.1 一般资料 　　将2009年6月～2012年12月本院收治的136例下肢单纯性静脉曲张患者随机分为两组，A组行大隐静脉高位结扎、主干与曲张静脉剥脱术共70例，其中男性39例，女性31例，年龄25～76岁，平均42.5岁，共78条腿，4例合并小腿溃疡，3例皮肤色素沉着明显；B组行大隐静脉高位结扎剥脱、小腿部曲张浅静脉皮下连续环形缝扎术共66例，其中男性34例，女性