巫志华 　邱耿锋 张贵荣

【摘要】 目的：探討大隐静脉高位结扎及腔内激光联合泡沫硬化剂腔内注射治疗下肢静脉曲张的临床效果。方法：选择2017年1月-2018年12月笔者所在医院接诊的下肢静脉曲张患者298例，按照随机数字表法分为对照组（n=149）和观察组（n=149）。对照组采用大隐静脉高位结扎联合腔内激光治疗，观察组在对照组治疗基础上实施泡沫硬化剂腔内注射，对比两组治疗效果。结果：观察组手术时间长于对照组，住院时间、医疗费用均少于对照组（t=-11.317、9.285、9.109，P<0.05）。两组失血量、切口数量对比，差异均无统计学意义（t=1.394、1.525，P>0.05）。术后1周，两组凝血功能和炎性因子均较术前改善（P<0.05）;观察组纤维蛋白原、白细胞介素-2、白细胞介素-10均低于对照组，凝血酶原时间长于对照组，差异均有统计学意义（t=12.682、-4.937、5.591、9.439，P<0.05）。观察组术后1个月治疗效果优于对照组（Z=3.781，P<0.05）。结论：大隐静脉高位结扎及腔内激光联合泡沫硬化剂腔内注射治疗下肢静脉曲张，可以提升治疗效果，改善术后凝血功能及炎性反应情况，促进患者恢复。

【关键词】 大隐静脉高位结扎 泡沫硬化剂 微创手术 下肢静脉曲张

doi：10.14033/j.cnki.cfmr.2019.28.005 文献标识码 A 文章编号 1674-6805（2019）28-00-03

Clinical Effect of High Ligation of the Great Saphenous Vein and Intracavitary Laser Combined with Intracavitary Injection of Sclerosing Foam in the Treatment of Varicose Veins of Lower Extremity/WU Zhihua， QIU Gengfeng， ZHANG Guirong. //Chinese and Foreign Medical Research， 2019， 17（28）： -14

[Abstract] Objective： To investigate the clinical effect of high ligation of the great saphenous vein and intracavitary laser combined with intracavitary injection of sclerosing foam in the treatment of varicose veins of lower extremity. Method： A total of 298 patients with varicose veins of lower extremity who were admitted to our hospital from January 2017 to December 2018 were selected. According to the method of random number， patients were divided into the control group （n=149） and the observation group （n=149）. The control group was treated with high ligation of the great saphenous vein and intracavitary laser treatment. The observation group was treated with intracavitary injection of sclerosing foam on the basis of the control group. The treatment effects of the two groups were compared. Result： The operation time of the observation group was longer than that of the control group， and the length of hospital stay and the medical expenses were less than those of the control group （t=-11.317， 9.285， 9.109， P<0.05）. The blood loss， the number of incisions were compared between the two groups， and the differences were not statistically significant （t=1.394， 1.525， P>0.05）. One week after the operation， coagulation function and inflammatory factors of the two groups were improved compared with those before operation （P<0.05）. The fibrinogen， interleukin-2 and interleukin-10 in the observation group were lower than those of the control group， and the prothrombin time was longer than that of the control group （t=12.682， -4.937， 5.591， 9.439， P<0.05）. The therapeutic effect of the observation group was better than that of the control group one month after operation （Z=3.781， P<0.05）. Conclusion： High ligation of the great saphenous vein and intracavitary laser combined with intracavitary injection of sclerosing foam for the treatment of varicose veins of lower extremity can improve treatment， improve postoperative coagulation and inflammatory response， and promote recovery of patients.

[Key words] High ligation of the great saphenous vein Sclerosing foam Minimally invasive surgery Varicose veins of lower extremities

First-authors address： Longyan Second Hospital， Longyan 364000， China

下肢静脉曲张是血管外科较为高发的疾病之一。研究认为，多种原因导致的静脉压力增加及血管壁薄弱等均可以诱发下肢静脉曲张[1]。临床一般表现为下肢肿胀、疼痛、皮肤色素沉着等，病情严重者可出现溃疡。随着医学科技的进步，利用微创手术治疗下肢静脉曲张已成为诸多医院的首选治疗策略。较为经典的大隐静脉高位结扎也可以通过微创的操作方式完成。在完成大隐静脉结扎后采用泡沫硬化剂腔内注射是近些年所使用的一种新型方法。研究发现，泡沫硬化剂对于静脉团或大隐静脉迂曲属支的治疗效果良好[2]。腔内激光治疗技术也是目前针对下肢静脉曲张使用较广泛的一种术式[3]。本研究选择2017年1月-2018年12月笔者所在医院接诊的下肢静脉曲张患者298例，对大隐静脉高位结扎及腔内激光联合泡沫硬化剂腔内注射治疗下肢静脉曲张的临床效果进行探讨，报道如下。……