静脉内热消融术（980 nm激光）联合泡沫硬化剂在下肢静脉曲张日间手术中的疗效分析

doi:10.3969/j.issn.1674-8115.2021.10.006

摘要/Abstract

摘要：

目的·对比分析下肢静脉曲张患者采用980 nm激光的静脉内热消融术（endovascular thermal ablation，EVTA）联合泡沫硬化剂日间手术（局部麻醉）与大隐静脉高位结扎+810 nm激光的EVTA联合泡沫硬化剂住院手术（全身麻醉）的治疗效果。方法·回顾性分析2019年3月—2020年3月于徐州矿务集团第一医院普通外科分别接受上述2种手术方式的患者，其中日间手术者111例（980 nm组）、住院手术者107例（810 nm组）。收集患者的基线数据、术后资料及随访资料，并对其组间差异进行比较。结果·2组患者在基线数据、随访资料间差异均无统计学意义。而在术后，980 nm组患者在疼痛评分、疼痛持续时间、使用止痛药者占比、恢复日常生活所需时间及经济成本方面均优于810 nm组（均P<0.05）。结论·静脉内热消融术（980 nm激光）联合泡沫硬化剂行日间手术治疗下肢静脉曲张在患者术后舒适度、住院时间及费用方面存在一定的优势，或将为不适合全麻手术的患者提供新的选择。

关键词: 980 nm激光, 下肢静脉曲张, 日间手术, 泡沫硬化剂

Abstract:

Objective·To compare and analyze the therapeutic effect of 980 nm laser endovascular thermal ablation (EVTA) combined with foam sclerotherapy on day surgery (local anesthesia) and high ligation of great saphenous vein+810 nm laser EVTA combined with foam sclerotherapy on inpatient surgery (general anesthesia) for patients with lower extremity varicose vein.

Methods·Data of the patients who underwent the above different surgical procedures respectively in the Department of General Surgery, The First Hospital of Xuzhou Mining Group from March 2019 to March 2020 were retrospectively analyzed, including 111 day surgery patients (980 nm group) and 107 inpatient surgery patients (810 nm group). The baseline data, postoperative data and follow-up data were collected, and the differences between the two groups were compared.

Results·There was no significant difference between the two groups in baseline data and follow-up data. After operation, the 980 nm group was better than the 810 nm group in pain score, duration of pain, the proportion of using painkillers, the time required to resume daily life and economic cost (all P<0.05).

Conclusion·Endovascular thermal ablation (980 nm laser) combined with foam sclerotherapy in the day surgery for lower extremity varicose vein has certain advantages in postoperative comfort, hospitalization time and cost, which will provide a new option for patients who are not suitable for general anesthesia.

Key words: 980 nm laser, lower extremity varicose vein, day surgery, foam sclerotherapy

中图分类号:

R654.6

李永传, 陆信武, 张志华, 秦金保, 张省. 静脉内热消融术（980 nm激光）联合泡沫硬化剂在下肢静脉曲张日间手术中的疗效分析[J]. 上海交通大学学报(医学版), 2021, 41(10): 1308-1312.

Yong-chuan LI, Xin-wu LU, Zhi-hua ZHANG, Jin-bao QIN, Xing ZHANG. Analysis of the efficacy of endovascular thermal ablation (980 nm laser) combined with foam sclerotherapy in day surgery for lower extremity varicose vein[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(10): 1308-1312.

图/表 3

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Item	810 nm group （n=107）	980 nm group （n=111）	P value
Gender （M/F）/n	58/49	49/62	0.137
Age/year	55.37±8.68	57.12±10.13	0.172
CEAP classification/n（%）
C3	31 （29.0）	28 （25.2）	0.534
C4	46 （43.0）	39 （35.1）	0.235
C5	30 （28.0）	44 （39.6）	0.071
Preoperative VCSS/score	8.48±3.74	9.19±2.75	0.113
Preoperative diameter of GSV/mm
at SFJ level	7.92±2.10	7.49±1.99	0.122
at knee level	5.63±0.67	5.78±0.59	0.081
Reflux time at SFJ level/ms	3 829.01±732.84	3 784.32±693.80	0.644

Item	810 nm group （n=107）	980 nm group （n=111）	P value
Gender （M/F）/n	58/49	49/62	0.137
Age/year	55.37±8.68	57.12±10.13	0.172
CEAP classification/n（%）
C3	31 （29.0）	28 （25.2）	0.534
C4	46 （43.0）	39 （35.1）	0.235
C5	30 （28.0）	44 （39.6）	0.071
Preoperative VCSS/score	8.48±3.74	9.19±2.75	0.113
Preoperative diameter of GSV/mm
at SFJ level	7.92±2.10	7.49±1.99	0.122
at knee level	5.63±0.67	5.78±0.59	0.081
Reflux time at SFJ level/ms	3 829.01±732.84	3 784.32±693.80	0.644

Item	810 nm group （n=107）	980 nm group （n=111）	P value
Pain score/score	3.67±1.32	2.14±0.91	0.000
Duration of pain/d	3.72±1.51	0.78±0.25	0.000
Use of painkiller/n（%）	16（15.0）	3 （2.7）	0.001
VCSS changes before and after operation/score	5.75±2.25	6.38±1.74	0.022
Time required to resume daily life/d	7.05±4.63	2.27±1.45	0.000
Economic cost/yuan	15 649.85±1 063.32	7 268.76±502.18	0.000

Item	810 nm group （n=107）	980 nm group （n=111）	P value
Pain score/score	3.67±1.32	2.14±0.91	0.000
Duration of pain/d	3.72±1.51	0.78±0.25	0.000
Use of painkiller/n（%）	16（15.0）	3 （2.7）	0.001
VCSS changes before and after operation/score	5.75±2.25	6.38±1.74	0.022
Time required to resume daily life/d	7.05±4.63	2.27±1.45	0.000
Economic cost/yuan	15 649.85±1 063.32	7 268.76±502.18	0.000

Item	810 nm group （n=107）	980 nm group （n=111）	P value
Severe complication/n（%）
lower extremity DVT	2 （1.9）	0 （0）	0.148
Others	0 （0）	0 （0）	‒
Minor complication/n（%）
Ecchymosis	31（29.0）	24 （21.6）	0.212
Edema	72 （67.3）	66 （59.5）	0.230
Paresthesia around ankle	9 （8.4）	6 （5.4）	0.381