目的 探讨泡沫硬化剂治疗复发性下肢静脉曲张的临床疗效。
方法 选择我院2011年1月至2012年3月期间23例(26条患肢)复发性下肢静脉曲张的患者,其中男9例,平均年龄58.6岁;女14例,平均年龄53.3岁。静脉曲张复发病史1个月~6年,平均3.2年。对其行超声引导下患肢曲张静脉内注射1%聚桂醇泡沫硬化剂后弹力袜压迫,治疗后3d、3个月超声检测曲张静脉闭合情况及有无深静脉血栓形成,3个月后不定期病房随访。
结果 23例患者均在超声引导下成功行泡沫硬化剂治疗,20例(22条患肢)注射1次,3例(4条患肢)注射2次,每例患者每次平均应用5ml泡沫硬化剂。末次注射结束后3d观察曲张静脉均成功闭合。平均随访6个月,治疗后1周2例出现轻度血栓性浅静脉炎,2周内自行缓解,均无严重并发症发生。治疗后3个月3例(4条患肢)局部复发,复发率15.4%,再次局部泡沫硬化剂治疗后至今未复发。10例(12条患肢)注射部位皮肤出现轻度色素沉着,3个月后减轻,6个月至1年消退。所有患者临床症状得到不同程度的缓解。
结论 泡沫硬化剂治疗复发性下肢静脉曲张近期疗效确切且并发症少。
Citation:
李光华,刘晓晨,李煜庆,豆发福,段建锋,周亚东. Foam Sclerosing Agent in Treatment for Recurrent Varicose Veins of Lower Extremities (23 Cases of Clinical Analysis). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(11): 1229-1231. doi:
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Hartmann K, Klode J, Pfister R, et al. Recurrent varicose veins:sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping[J]. Vasa, 2006, 35(1):21-26.
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Viani MP, Poggi RV, Pinto A, et al. Re-exploration of the saphenofemoral junction in the treatment of recurrent varicose veins[J]. Int Surg, 1996, 81(4):382-384.
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Breu FX, Guggenbichler S, Wollmann JC, et al. Duplex ultrasound and efficacy criteria in foam sclerotherapy from the 2nd European Consensus Meeting on Foam Sclerotherapy 2006, Tegernsee, Germany[J]. Vasa, 2008, 37(1):90-95.
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Ramelet AA, Kern P, Perrin M. Varicose veins and telangiectasias[M]. Paris:Elsevier SAS, 2004:88-91.
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Goldman MP, Bergan JJ, Guex JJ. Sclerotherapy:Treatment of Varicose and Telangiectactic Leg Veins[M]. 4th edn. Philadelphia:Mosby Elsevier, 2007:33-36.
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Scultetus AH, Villavicencio JL, Kao TC, et al. Microthrombectomy reduces postsclerotherapy pigmentation:multicenter randomized trial[J]. J Vasc Surg, 2003, 38(5):896-903.
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- 1. Royle JP. Recurrent varicose veins[J]. World J Surg, 1986, 10(6):944-953.
- 2. Kostas T, Ioannou CV, Touloupakis E, et al. Recurrent varicose veins after surgery:a new appraisal of a common and complex problem in vascular surgery[J]. Eur J Vasc Endovasc Surg, 2004, 27(3):275-282.
- 3. Winterborn RJ, Foy C, Earnshaw JJ. Causes of varicose vein recurrence:late results of a randomized controlled trial of stripping the long saphenous vein[J]. J Vasc Surg, 2004, 40(4):634-639.
- 4. Bergan J. Sclerotherapy:a truly minimally invasive technique[J]. Perspect Vasc Surg Endovasc Ther, 2008, 20(1):70-72.
- 5. Drake LA, Dinehart SM, Goltz RW, et al. Guidelines of care for sclerotherapy treatment of varicose and telangiectatic leg veins[J]. J Am Acad Dermatol, 1996, 34(3):523-528.
- 6. van Rij AM, Jiang P, Solomon C, et al. Recurrence after varicose vein surgery:a prospective long-term clinical study with duplex ultrasound scanning and air plethysmography[J]. J Vasc Surg, 2003, 38(5):935-943.
- 7. Hartmann K, Klode J, Pfister R, et al. Recurrent varicose veins:sonography-based re-examination of 210 patients 14 years after ligation and saphenous vein stripping[J]. Vasa, 2006, 35(1):21-26.
- 8. Rutherford EE, Kianifard B, Cook SJ, et al. Incompetent perforating veins are associated with recurrent varicose veins[J]. Eur J Vasc Endovasc Surg, 2001, 21(5):458-460.
- 9. Viani MP, Poggi RV, Pinto A, et al. Re-exploration of the saphenofemoral junction in the treatment of recurrent varicose veins[J]. Int Surg, 1996, 81(4):382-384.
- 10. Canonico S, Campitiello F, Lauletta V, et al. Diagnostic and surgical approaches to recurrent varicose veins of lower limbs[J]. Panminerva Med, 1997, 39(4):287-290.
- 11. Eklof B, Juhan C. Recurence of varicose veins// Eklof B, Gores JE, Thulesius O, et al, eds. Controversies in Management of Venous Disorders[M]. London:Butterworths, 1989:220-233.
- 12. Breu FX, Guggenbichler S, Wollmann JC, et al. Duplex ultrasound and efficacy criteria in foam sclerotherapy from the 2nd European Consensus Meeting on Foam Sclerotherapy 2006, Tegernsee, Germany[J]. Vasa, 2008, 37(1):90-95.
- 13. Ramelet AA, Kern P, Perrin M. Varicose veins and telangiectasias[M]. Paris:Elsevier SAS, 2004:88-91.
- 14. Goldman MP, Bergan JJ, Guex JJ. Sclerotherapy:Treatment of Varicose and Telangiectactic Leg Veins[M]. 4th edn. Philadelphia:Mosby Elsevier, 2007:33-36.
- 15. Scultetus AH, Villavicencio JL, Kao TC, et al. Microthrombectomy reduces postsclerotherapy pigmentation:multicenter randomized trial[J]. J Vasc Surg, 2003, 38(5):896-903.