超声定位穿静脉结扎对下肢静脉性溃疡术后愈合影响的临床研究

目的:观察下肢静脉性溃疡患者穿静脉功能不全情况,探讨超声定位下肢穿静脉结扎对下肢静脉性溃疡术后疗效的影响。方法:40例大隐静脉曲张患者随机分成两组:A组采用大隐静脉高位结扎、静脉腔内微波射频闭合术及超声定位穿静脉结扎治疗,B组采用大隐静脉高位结扎和静脉腔内微波射频闭合术治疗。观察两组患者治疗后静脉性溃疡的愈合时间、复发率及瓣膜功能不全穿静脉数量部位,并比较两组患者临床预后评分。结果:术前两组瓣膜功能不全穿静脉数量分别是47条和44条,两组比较差异无统计学意义(P=0.5520)。术后两组愈合时间分别是(7.5±4.389)周和(11.6±6.489)周,两组比较差异具有统计学意义(P=0.048)。两组临床预后评分分别为(2.3±0.6)分和(1.1±1.5)分,两组比较差异具有统计学意义(P=0.042)。结论:多普勒超声可有效检测定位瓣膜功能不全的下肢穿静脉,在超声定位下行大隐静脉高位结扎、静脉腔内微波射频闭合术联合穿静脉结扎治疗下肢静脉性溃疡的疗效优于穿静脉不结扎。

Clinical Study on Effects of Ultrasound Assisted Perforating Vein Ligation onthe Healing of Venous ulcer of Lower Limb

Objective:To observe the effects of ultrasound assisted perforating vein ligation on the healing of lower limb ulcer.Methods:40 patients with great saphenous varicosis were selected and randomly divided into two groups. The patients in group A weretreated with high ligation of great saphenous vein, endovenous microwave and perforating vein ligation, while the patients in group Bwere treated with high ligation of great saphenous vein and endovenous microwave radiofrequency endovenous treatment. Then the ulcerhealing time, recurrence rate, the numbers and positions of the insufficiency perforating veins and the clinical outcome scores were observedand compared between the two groups.Results:The insufficiency perforating veins of the two groups before operation were 47and 44, respectively, and there was no statistically significant difference between the two groups (P=0.5520). The healing time of group Awas (7.5± 4.389) weeks which was shorter than (11.6± 6.489) weeks of group B with statistically significant difference (P=0.048). Andthe clinical outcome of group A was (2.3± 0.6) which was significantly higher than (1.1± 1.5) of group B with statistically significantdifference (P=0.042).Conclusion:Doppler ultrasound can effectively locate the insufficiency perforating vein of the lower limb. WithDoppler ultrasound, the combination of great saphenous vein ligation, endovenous microwave treatment and perforating vein ligation hasbetter outcome in venous ulcer treatment than the method without perforating vein ligation.