微小切口点状抽剥联合驱血带在下肢浅静脉曲张抽剥术中的应用

摘要

目的：探讨微小切口点状抽剥联合驱血带在下肢静脉曲张抽术中的应用效果。方法：选取2012年4月-2014年7月在本院应用微小切口点状抽剥联合驱血带治疗下肢浅静脉曲张87例患者（91条肢体）作为A组，另选取使用传统曲张静脉节段切除的传统方法治疗的85例患者（88条肢体）作为B组，回顾性分析两组患者的临床资料。比较两组患者的手术时间、住院时间，观察术后皮下淤血、血肿、肢体麻木等情况。结果：A组的平均手术时间（68±14.5）min和平均住院时间（7.2±1.3）d均明显短于B组的（79±13.6）min和（8.9±1.1）d，差异均有统计学意义（P<0.05）。A组无肿胀不适，切口无淤血、血肿，无患肢麻木等并发症。B组中3例患者出现淋巴漏，1例淋巴感染，2例患者小腿切口轻度水肿，13例患者小腿切口淤血、血肿，3例患肢足靴区麻木。术后随访6~24个月，A组效果良好，未见明显瘢痕，复发患者2例。B组小腿淤血、肿胀，在1~2月内消退，3例下肢麻木患者，其中2例缓解，1例未见明显缓解，3例复发。所有患者小腿可见多出明显手术瘢痕。结论：微小切口点状抽剥能够减少创伤面积，降低皮肤感觉障碍，抽剥彻底，术后复发率低；驱血可创造无血手术野，缩短手术时间，为彻底抽剥曲张静脉创造条件。微小切口点状抽剥脱联合驱血带在治疗下肢静脉曲张中是一种值得推广的简便、经济、实用的方案。%Objective:To investigate the application effect of minimally incision punctate stripping combined with tourniquet in limb varicose vein stripping surgery.Method:87 patients(91 limbs)with lower limb varicose vein received the treatment of surgery by minimally incision punctate stripping combined with tourniquet in our hospital from April 2012 to July 2014 were selected as the group A,while 85 patients(88 limbs)received treatment of traditional surgery of segmental resection were selected as the group B.The clinical data of two groups were retrospectively analyzed. The operative time,hospital stay of the two groups were compared,postoperative subcutaneous congestion,hematoma, numbness in the two groups were observed.Result:the average of operative time was(68±14.5)min and average of hospital stay was(7.2±1.3)d in group A,they were significantly shorter than(79±13.6)min and(8.9±1.1)d in group B,the differences were statistically significant(P<0.05).In group A,without swelling,discomfort,congestion in the cut,hematoma and complications such as limb numbness.In group B,3 cases had lymphatic leakage,one case with lymphatic infection,two cases with mild edema of the leg incision,13 cases with hematoma,and 3 cases with limb numbness.All patients were followed up for 6-24 months.The efficacy of group A was good,with no obvious scars and relapse in 2 cases.In group B:calf congestion and swelling disappeared in 1-2 months;three cases had lower extremity numbness,including two cases of remission and one case of no obvious relief.Three cases recurred.All patients had visible surgical scars.Conclusion:Minimally incision punctate stripping can reduce the the skin numbness and the skin feeling obstacle,stripping completely,low recurrence rate after surgery,tourniquet can create a bloodless surgical field, shorten the operative time,create conditions for cleanly stripping varicose vein.Minimally incision punctate stripping combined with tourniquet in limb varicose vein stripping surgery is a simple,economic,practical scheme,is worthy of clinical promotion.