PDF《冷光源引导下泡沫硬化剂注射小腿曲张 浅静脉在下肢静脉溃疡...》

中华普通外科学文献 (电子版)

2015 年2月第

9 卷第

1 期Chin Arch Gen Surg (Electronic Edition), February 2015, Vol.

9, No.1 窑 论著 窑DOI: 10.3877/cma.j.issn.1674-0793.2015.01.006 作者单位:510120 广州,中山大学孙逸仙纪念医院血管外科 通讯作者:黎洪浩,Email:[email protected] 冷光源引导下泡沫硬化剂注射小腿曲张 浅静脉在下肢静脉溃疡治疗中的 应用探讨 龙淼云 罗定远 彭新治 黄楷 黄明清 林少建 黎洪浩 揖摘要铱 目的 探讨冷光源引导下泡沫硬化剂注射小腿曲张浅静脉联合腔镜深筋膜下交通 支静脉离断术(SEPS)及大隐静脉高位结扎抽剥术治疗下肢交通静脉功能不全所致的静脉溃疡中 的作用效果遥 方法 选取

2012 年6月至

2013 年5月就诊的

42 例(46 条患肢)小腿交通静脉功能 不全合并浅静脉曲张的静脉溃疡患者,行SEPS 术及大隐静脉高位结扎抽剥术,并在 SEPS 术的冷光 源引导下行小腿曲张静脉泡沫硬化剂注射术遥结果 共注射

263 条曲张浅表静脉遥随访期间所有患 者静脉溃疡均愈合遥

9 例患者的

9 条下肢(9/46,19.57%)在术后

4 周内出现局部疼痛,口服止疼药可 缓解遥

22 例患者的

24 条下肢(24/46,52.17%)共46 条静脉(46/263,17.49%)在术后

1 ~

2 周出现沿治 疗曲张静脉行程的黄褐色色素沉着,于3~6个月内自行消失遥

3 例患者

3 条下肢(3/46,6.52%)共11 条静脉(11/263, 4.18%)在治疗后

1 周出现沿曲张静脉分布的红尧热尧痛和压痛,诊断为浅表性静脉 炎,外用多磺酸黏多糖乳膏后缓解遥 经过注射的

263 条曲张静脉中,245 条(245/263,93.16%)达到治 疗成功标准,18 条(18/263,6.84%)达到部分成功标准,无一条静脉未成功注射遥结论 冷光源引导下 的小腿曲张静脉泡沫硬化剂注射联合 SEPS 术及大隐静脉高位结扎抽剥术是良好的治疗交通静脉 功能不全所致静脉溃疡的方法,其长期作用效果有待进一步观察遥 揖关键词铱 静脉溃疡;

泡沫硬化剂;

冷光源 Clinical efficacy of cold light source-guided foam sclerotherapy with lauromacrogol for venous ulcer of the lower extremities Long Miaoyun, Luo Dingyuan, Peng Xinzhi, Huang Kai, Huang Mingqing, Lin Shaojian, Li Honghao. Department of Vascular Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China Corresponding author: Li Honghao, Email: [email protected] 揖Abstract铱Objective To observe the clinical efficacy of cold light source -guided foam sclerotherapy with lauromacrogol combining subfascial endoscopic perforator surgery (SEPS) and long saphenous vein flush ligation and stripping for venous ulcer of the lower extremities. Methods From June

2012 to May 2013, forty-two patients with forty-six lower limbs of venous ulcer induced by incompetent perforator veins were treated. All the patients were performed SEPS, long saphenous vein flush ligation and stripping, and cold light source-guided foam sclerotherapy with lauromacrogol. Results Foam was injected to

263 veins by cold light-guided source. All venous ulcers were found recovered from a 3- to 12-month followed up. Nine patients felt pain in lower limbs and were given painkillers. Forty-six veins(17.49%) of

22 patients showed pigmentation following the varicosities one to two weeks after surgery. It disappeared in 3-6 months. Eleven veins (4.18%) of

3 lower extremities (6.52%) of

3 patients with varicosities demonstrated phlebitis and recovered after using Hirudoid. Two hundred and forty-five veins (93.16%) of treated varicosities achieved complete success criteria;