高位结扎加电凝术与传统手术治疗大隐静曲张的疗效比较-外科学专业论文.docxVIP

—１— —１— 摘 要 高位结扎加电凝术与传统手术治疗 大隐静曲张的疗效比较 研究生：梅敏杰 导师：段永亮 副教授 摘 要 目的：比较高位结扎加电凝术与传统的高位结扎加剥脱术治疗大隐静脉曲张的 临床疗效。方法：收集 240 例（308 条肢体）在我院行手术治疗的大隐静脉曲张患者， 根据手术方式不同分为两组。电凝组 140 例（180 条肢体）：行大隐静脉高位结扎加 电凝术，使大隐静脉主干及其属支闭塞。剥脱组 100 例（128 条肢体）：采用传统手 术方法（高位结扎和剥脱术）治疗。比较两组在手术时间、术后住院天数、手术切 口、术后疼痛、术后并发症、复发率等指标方面的差别。结果: 电凝组共 34 例，剥 脱组共为 95 例手术切口多于 2 个；电凝组切口长度为 5.8±1.8cm，剥脱组为 8.2±2.1cm； 手术时间电凝组为 46.6±5.9min，剥脱组为 63.3±7.0min；术后平均住院天数电凝组为 7.8±2.2 天，剥脱组为 11.9±2.8；电凝组术后 4 例服用止痛药物，剥脱组为 21 例服用 止痛药物。在术后并发症方面（皮下瘀斑、局部麻木感、皮下条索牵拉感、感染） 电凝组明显少于剥脱组（p＜0.05；两组短期复发率比较差别无统计学意义（p＞0.05）。 结论:大隐静脉“高位结扎+电凝”术的临床综合疗效明显优于传统手术方法“高位结扎 +剥脱”术，值得临床推广应用。 关键词：电凝术;大隐静脉静脉曲张;高位结扎+剥脱 —２— —２— 新疆医科大学医学硕士学位论文 Evaluation of results between highligation add electrocoagulation and traditional surgical of varicose great saphenous Postgraduate: Mei Minjie Supervisor: Duan Yongliang Vice Professor Abstract Objective: To evaluate the result of varicosis in the great saphenous vein between highligation and electrocoagulation procedure and highl- igation and stripping procedure .Methods：240(308 limbs)patients with varicose veins of lower extremity were enrolled to accept surgical management of vein syst- ems. All patients were randomized devide into two groups respectively according to the operating style.The electrocoagulation group (140case wih 180 limbs) was giv- en proximal saphenous vein ligation before the wall of greater saphenous vein was treated with power of electrocoagulate ,to occlude the whole length of the vein and other collaterals.The stripping group (100case wih 128 limbs) was given proximal saphenous vein ligation and ablation of varicose veins.To compare and analyse the operation incision,the surgery duration, the postoperative recovery time, the post- operative complications between the two groupes.Results:In the electrocoa- gulation group 34 limbs has more than 2 incisions, 95 limbs in stripping group has more than 2 incisions.The average incision length of electrocoagulation group,was (5.8 ± 1.8)cm and the stripping grou