首页> 中文期刊> 《中国血管外科杂志(电子版)》 >两种不同手术方式治疗原发性下肢深静脉瓣膜功能不全的对比研究

两种不同手术方式治疗原发性下肢深静脉瓣膜功能不全的对比研究

         

摘要

Objective To compare the efficacy and the complications of TriVex phlebectomy combined with endovenous laser treatment (EVLT) and traditional high ligation and stripping of the great saphenous vein combined with encircling constriction of the superficial femoral vein in the treatment of primary deep venous insufficiency (PDVI). Methods From February 2010 to July 2014, 108 PDVI patients (137 legs) with CEAP classification C2~4 level in our centre were randomly divided into experiment group (TriVex phlebectomy combined with EVLT) and control group (traditional high ligation and stripping of great saphenous vein combined with encircling constriction of superficial femoral vein ). The clinical efficacy and postoperative complications of two groups were compared and analyzed. Results Symptoms of all patients were improved in different degrees and the effective rate was 100%. The treatments of two groups could controlled blood reflux effectively. The therapeutic effect of the experiment group was much better than that of control group in surgery time , blood loss in surgery , hospital stays , number of incision and postoperative lymphedema (P<0.05). There were no statistically significant differences in incision infection , subcutaneous ecchymosis, induration, skin numbness and deep vein thrombosis between two groups. Conclusion Both surgical operations are safe and effective in treatment of PDVI. However , TriVex phlebectomy combined with EVLT has advantages of little trauma and quick recovery , which is worth to be popularized.%目的:比较TriVex旋切术联合腔内激光与大隐静脉高位结扎剥脱术联合股浅静脉戴戒术治疗原发性下肢深静脉瓣膜功能不全(PDVI)的疗效和并发症。方法将2010年2月至2014年7月本院收治CEAP分级为C4级以下108例PDVI患者(137条患肢),分为观察组(TriVex 旋切术联合腔内激光治疗)和对照组(传统大隐静脉高位结扎剥脱术联合股浅静脉戴戒术),对比观察两组临床疗效和术后并发症。结果患者肢体症状均不同程度缓解,有效率100%,两组手术方式均能明显改善症状和有效控制血液反流;观察组手术时间、住院时间、术中出血量、切口数和术后淋巴水肿比较结果优于对照组,差异有统计学意义(P<0.05);切口感染、皮下瘀斑、硬结、皮肤麻木及深静脉血栓形成两组差异无统计学意义。结论两种手术方式均是治疗PDVI安全、有效的手段,但TriVex旋切术联合腔内激光治疗术具有创伤小、恢复快,值得推广开展。

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