超声引导下射频消融治疗联合泡沫硬化治疗对下肢静脉曲张疼痛应激反应、血流动力学及凝血功能的影响

摘要 目的：探讨与分析超声引导下射频消融联合泡沫硬化治疗对下肢静脉曲张疼痛应激反应、血流动力学及凝血功能的影响。方法：2021年8月到2022年5月选择在本院诊治的下肢静脉曲张60例作为研究对象，根据简单分配原则把患者分为联合组与泡沫硬化组各30例。联合组给予超声引导下泡沫硬化联合射频消融治疗，泡沫硬化组给予超声引导下泡沫硬化治疗，观察与记录患者疼痛应激反应、血流动力学及凝血功能变化情况。结果：两组术后1 d的疼痛VAS评分都显著低于术前1 d（P<0.05），联合组也显著低于泡沫硬化组（P<0.05）。两组术后1 d的血清缓激肽（BK）、P物质（SP）含量都显著低于术前1 d（P<0.05），联合组也显著低于泡沫硬化组（P<0.05）。两组术后1周的血浆纤维蛋白原（Fib）、纤溶酶原激活物抑制物（PAI-1）都低于术前1 d（P<0.05），联合组也显著低于泡沫硬化组（P<0.05）。联合组术后1个月的总有效率为100.0 %，明显高于泡沫硬化组的86.7 %（P<0.05）。结论：相对于泡沫硬化，超声引导下射频消融联合泡沫硬化治疗下肢静脉曲张能改善患者的凝血功能，还能有效缓解疼痛，改善患者的血流动力学状况，提高总体治疗效果。

Effects of Ultrasound-guided Radiofrequency Ablation Combined with Foam Sclerotherapy on Pain Stress Response, Hemodynamics and Coagulation Function of Lower Extremity Varicose Veins

ABSTRACT Objective: To explore and analyze the effect of ultrasound-guided radiofrequency ablation combined with foam sclerosis treatment on the lower limb varicose vein pain stress response, hemodynamics and coagulation function. Methods: From August 2021 to May 2022, 60 cases of lower extremity varicose veins diagnosed and treated in our hospital were selected as the research objects, and the patients were divided into Joint group and foam sclerosis group with 30 cases in each group according to the simple allocation principle. The ultrasound-guided foam sclerosis combined with radiofrequency ablation therapy, and the foam sclerosis group gave ultrasound-guided foam sclerosis therapy, and the changes of pain stress response, hemodynamics and coagulation function were observed and recorded. The pain stress response, hemodynamics and coagulation function changes were observed and recorded. Results: The VAS scores of pain in the two groups at 1 d after operation were lower than those at 1d before operation (P<0.05), and the Joint group were also lower than that in the foam sclerosis group(P<0.05). The serum levels of bradykinin (BK) and Substance P (SP) in the two groups were lower than those in the preoperative day 1(P<0.05), and the joint group were also lower than the foam sclerosis group group (P<0.05). Plasma fibrinogen (Fib) and plasminogen activator inhibitor (PAI-1) in both groups at 1 week after operation were lower than those at 1 day before operation(P<0.05). Compared with the foam sclerosis group group, the joint group also decreased (P<0.05). The total effective rate 1 month after surgery in the joint group were 100.0 %, which were higher than that in the foam sclerosis group (86.7 %) (P<0.05). Conclusion: Compared with foam sclerosis, ultrasound-guided radiofrequency ablation combined with foam sclerosis for lower limb varicose veins can improve the coagulation function, effectively relieve pain, improve the hemodynamic condition of patients, and improve the overall treatment effect.