【摘要】 目的比较钬激光与传统手术治疗下肢静脉曲张的临床效果。方法2005年3月~2006年12月,对226例(274条患肢)下肢静脉曲张分别采用钬激光治疗120例(148条患肢)(钬激光组),传统大隐静脉高位结扎加抽剥术106例(126条患肢)(传统组)。结果与传统组相比,钬激光组手术时间短[(38.0±10.8)minvs(61.5±12.3)min,t=-15.294,P=0.000],术后需止痛剂患者比例少[0%(0/120)vs54.7%(58/106),χ2=88.329,P=0.000],下床活动早[(6.2±0.8)hvs(22.5±1.5)h,t=-105.034,P=0.000],术后住院时间短[(3.0±0.5)dvs(8.5±2.5)d,t=-23.632,P=0.000],并发症发生率相近[16.9%(25/148)vs18.3%(23/126),χ2=0.087,P=0.768],1年复发率相近[3.8%(3/78)vs3.1%(2/65),χ2=0.000,P=1.000]。结论钬激光治疗下肢静脉曲张具有能明显缩短手术时间及住院时间,减少切口数量,术后疼痛轻,可早期下床活动等优点。保证疗效的关键是大隐静脉主干的有效灼闭,必要时应同时行大隐静脉高位结扎。更多还原

【Abstract】 Objective To compare the efficacy of holmium laser and traditional surgery for the treatment of varicosis of the lower limbs.Methods From March 2005 to December 2006,226 patients with varicosis of the lower limbs(274 limbs)were treated using holmium laser(laser group,120 patients with 148 diseased limbs)or high ligation and stripping of the great saphenous vein(traditional group,106 patients with 126 diseased limbs).Results The mean operation time of the laser group was significantly shorter than that in the traditional group [(38.0±10.8)min vs(61.5±12.3)min,t=-15.294,P=0.000].None of the patients in the laser group need analgetics after the operation,while 58 patients in the traditional group received the drug after the surgery(0 vs 54.7%,χ2=88.329,P=0.000).The patients in the laser group returned to activities earlier and had shorter postoperative hospital stay than those in the traditional group [(6.2±0.8)h and(3.0±0.5)d vs(22.5±1.5)h and(8.5±2.5)d;t=-105.034,P=0.000 and t=-23.632,P=0.000,respectively].The rates of complications and 1-year recurrence were similar in the two groups [16.9%(25/148)vs 18.3%(23/126),χ2=0.087,P=0.768 and 3.8%(3/78)vs 3.1%(2/65),χ2=0.000,P=1.000].Conclusions Holmium laser has advantages of shorter operation time and hospital stay,fewer surgical incisions,milder postoperative pain,and earlier return to activities.Closure of the great saphenous vein is the key to ensure the effect of laser therapy.High ligation of the great saphenous vein should be done simultaneously if necessary.更多还原