| 摘要: |
| 目的 探讨超声引导下射频消融联合泡沫硬化剂治疗不同管径大隐静脉曲张及超声在术后短期疗效评估的价值。方法 选取我院收治的大隐静脉曲张患者145例（145条患肢），根据术前超声测量大隐静脉大腿段最大管径分为A组98例（管径＜10 mm）和B组47例（管径≥10 mm），两组均采用超声引导下腔内射频消融大隐静脉主干和泡沫硬化剂治疗小腿曲张浅静脉。比较两组消融次数和术后即刻、1个月、6个月大隐静脉闭塞率、残余管腔管径，以及术后并发症情况。结果 B组每节段平均消融次数大于A组，差异有统计学意义（P＜0.05）。A组、B组术后即刻大隐静脉闭塞率均为100%，术后1个月大隐静脉闭塞率分别为97.96%、100%，术后6个月大隐静脉闭塞率分别为95.92%、95.74%，两组各时间点大隐静脉闭塞率比较差异均无统计学意义。术后1个月、6个月B组残余管腔管径均大于A组，差异有统计学意义（均P＜0.05）。术后两组患者均未出现深静脉血栓、肺栓塞等严重并发症，两组出现皮下瘀斑和皮肤灼伤占比比较差异无统计学意义；B组出现皮下条索僵硬静脉占比大于A组，差异有统计学意义（P＜0.05）。结论 超声引导下射频消融联合泡沫硬化剂治疗不同管径大隐静脉曲张短期内大隐静脉闭塞率较高，较大管径的大隐静脉消融可能需要更多的消融周期，超声在术中监测、术后随访和疗效评估中均有重要的作用。 |
| 关键词: 超声引导 射频消融 大隐静脉曲张 管径 |
| DOI： |
| 投稿时间：2023-02-25修订日期：2023-09-09 |
| 基金项目: |
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| Clinical value of ultrasound-guided radiofrequency ablation combined with foam sclerosing agent in the treatment of great saphenous vein varices of different diameters |
| zengxin,zengxin,yeming,wangbisi,chenrui,tangxueyao,zhouhong |
| (The Third People&The Third People&#;&s Hospital of Chengdu) |
| Abstract: |
| Objective：To explore the value of ultrasound-guided radiofrequency ablation combined with foam sclerosing agent in the treatment of great saphenous vein varices of different diameters and the short-term effect evaluation of ultrasound after operation.Methods：145 patients （145 affected limbs） with great saphenous vein varicose were selected from our hospital.According to the preoperative ultrasound measurement of the maximum diameter of the great saphenous vein thigh segment，they were divided into group A （98 cases）（diameter＜10 mm） and group B （47 cases）（diameter ≥ 10 mm）.Both groups were treated with ultrasound guided intracavitary radiofrequency ablation of the main great saphenous vein and foam sclerosing agent to treat superficial varicose veins of the lower leg. Compare the frequency of ablation and the occlusion rate of the great saphenous vein immediately, 1 month, and 6 months after surgery, residual lumen diameter, and postoperative complications between the two groups. Results：The average ablation frequency of each segment in Group B was greater than that in Group A, and the difference was statistically significant （P＜0.05）.The immediate occlusion rates of the great saphenous vein in Group A and Group B were 100%, and the occlusion rates of the great saphenous vein one month after surgery were 97.96% and 100%, respectively. The occlusion rates of the great saphenous vein six months after surgery were 95.92% and 95.74%, respectively. There was no statistically significant difference in the occlusion rates of the great saphenous vein between the two groups at different time points. At 1 month and 6 months after surgery, the residual lumen diameter of Group B was greater than that of Group A, and the difference was statistically significant（all P＜0.05）. There were no serious complications such as deep vein thrombosis or pulmonary embolism in both groups of patients after surgery, and there was no statistically significant difference in the proportion of subcutaneous ecchymosis and skin burns between the two groups; The proportion of subcutaneous cord stiffness veins in Group B was higher than that in Group A, and the difference was statistically significant （P＜0.05）.Conclusion：Ultrasound guided radiofrequency ablation combined with foam sclerosing agent has a high occlusion rate of great saphenous vein in the short term in the treatment of varices of great saphenous vein with different diameters. Ablation of great saphenous vein with larger diameters may require longer ablation cycles. Ultrasound plays an important role in intraoperative monitoring, postoperative follow-up and efficacy evaluation. |
| Key words: Ultrasound guidance Varicose great saphenous vein Radiofrequency ablation Diameter |
