聚桂醇泡沫硬化剂注射与腔内电凝治疗下肢静脉曲张的疗效对比

摘要

Objective To compare the efficacy of lauromacrogol sclerotherapy and intracavity electrocoagulation in the treatment of varicose vein of lower limb. Methods A total of 132 patients from China National Petroleum Corporation Central Hospital from August 2012 to July 2013,with varicose vein of lower limb(168 limbs)were enrolled and divided into group A and group B according to the random number table method,with 64 patients(84 limbs)in group A and 68 patients(84 limbs)in group B. Group A was administrated with high ligation and stripping of great saphenous vein ﹢ intracavity electrocoagulation,and group B was administrated with high ligation and stripping of great saphenous vein ﹢ lauromacrogol sclerotherapy. Analysis was made on duration of operation,expense on consumable items,complication of surgery,postoperative recurrence and ulcer recovery. Results Both groups finished surgery successfully. The average duration of surgery on a lesion limb was(37. 0 ± 3. 5) min for group A and(34. 0 ± 4. 6) min for group B,without significant difference between the two groups(t = 0. 476,P ﹥0. 05). The average expense on consumable items was(19. 5 ± 0. 6)yuan for group A and(710. 4 ± 50. 5)yuan for group B, with group A lower than group B(t = 3. 845,P ﹤ 0. 01). After surgery,2 cases of skin burn,2 cases of thrombophlebitis and 8 cases of saphenous nerve injury occurred in group A;3 cases of thrombophlebitis and 3 cases of saphenous nerve injury occurred in group B. The two groups had significant difference in the incidence of complications(χ2 = 1. 556,P ﹥ 0. 05). During the one - year follow - up after surgery,group A had 8 cases of recurrence and group B had one case of recurrence,there was significant difference between the two groups(χ2 = 4. 226,P ﹤ 0. 05). The healing time of ulcer was(46. 0 ± 1. 5) days for group A and(18. 0 ± 2. 0) days for group B,with significant difference between the two groups( t = 2. 342,P ﹤ 0. 05). Conclusion The two therapies both have marked efficacy in the treatment of varicose vein of lower limb. Lauromacrogol sclerotherapy needs more expense than intracavity electrocoagulation does,while lauromacrogol sclerotherapy has more advantage in the treatment of ulceration and fewer incidence of recurrence rate after surgery.%目的：探讨泡沫硬化剂与腔内电凝治疗浅静脉曲张的疗效对比。方法选择中国石油天然气集团公司中心医院2012年8月—2013年7月收治的132例下肢静脉曲张患者（168条肢体），按照随机数字表法分为 A 和 B 两组，A 组64例患者（84条肢体）行大隐静脉高位结扎剥脱﹢腔内电凝术，B 组68例患者（84条肢体）行大隐静脉高位结扎剥脱﹢聚桂醇泡沫硬化剂栓塞治疗。对两组的手术时间、耗材费用、手术并发症、术后复发情况、溃疡好转情况等进行对比分析。结果两组患者均成功完成手术；A 组每条患肢平均手术时间为（37.0±3.5）min，B 组每条患肢平均手术时间为（34.0±4.6）min，两组间差异无统计学意义（t ＝0.476，P ﹥0.05）。A 组耗材平均费用为（19.5±0.6）元，B 组耗材平均费用为（710.4±50.5）元，A 组费用较 B 组明显降低，差异有统计学意义（t ＝3.845，P ﹤0.01）。A 组术后出现皮肤烧伤2例，血栓性静脉炎2例，隐神经损伤8例，B 组出现血栓性静脉炎3例，隐神经损伤3例，两组并发症发生率间差异无统计学意义（χ2＝1.556，P ﹥0.05）；术后随访1年，A 组复发8例，B 组复发1例，两组复发率间差异有统计学意义（χ2＝4.226，P ﹤0.05）；A 组患者溃疡愈合时间为（46.0±1.5）d，B 组溃疡愈合时间为（18.0±2.0）d，两组间差异有统计学意义（t ＝2.342，P ﹤0.05）。结论两种术式治疗下肢静脉曲张疗效均显著。聚桂醇泡沫硬化剂注射相对腔内电凝治疗费用略高，但对于治疗溃疡有一定优势，术后复发率相对较少。