【摘要】 目的探讨大隐静脉主干射频消融治疗中的性别差异及彩色多普勒血管成像(CDFI)应用体会。方法 2018年3月1日～2019年6月1日武汉某三甲医院血管外科收治72例大隐静脉曲张患者,其中70例大隐静脉曲张(94条)患者进行围手术期CDFI评估,并局麻下实施进行大隐静脉主干射频消融治疗,分析大隐静脉射频消融治疗中CDFI的重要性及应用体会。结果 72例就诊患者中70例顺利完成彩超引导下的大隐静脉射频消融,且术后均顺利出院,虽然未加行大隐静脉高位结扎,围手术期未发生深静脉血栓、肺栓塞等严重并发症;术后1月复查,大隐静脉主干均完全闭合。患者患肢不适症状(如水肿、疼痛、酸胀、沉重感、麻木等)均明显缓解或消失。男性/女性病人在年龄、手术部位、CEAP分级、大隐静脉主干返流时间、大隐静脉主干返流速度的差异均无统计学意义(P>0.05);在大隐静脉主干内径比较上,男性/女性病人在左下肢的差异无统计学意义(P>0.05),而在右下肢大隐静脉内径的差异存在统计学意义(P<0.05)。结论 CDFI在大隐静脉曲张患者围手术期评估具有重要的作用,术前明确病变及手术方案选择、射频术中发挥引导作用,术后复查评估综合治疗效果。无高位结扎的大隐静脉射频消融术具有满意的短期效果,无严重并发症;女性病人右下肢大隐静脉内径明显小于男性病人右下肢大隐静脉内径。更多还原

【Abstract】 Objective To explore the gender differences in endovenous radio-frequency ablation(RFA) of great saphenous varicosis vein(GSVV) and evaluate the application ande experience of color Doppler flow imaging(CDFI). Methods We included 72 patients with GSVV(96 extremities) in vascular surgery department, and 70 patients(94 extrenities) underwent endovenous RFA from March 2018 to June 2019, in a third-class hospital of Wuhan. CDFI examination was performed before,during and after operation. Then results were analyzed to assess the importance and experience of the CDFI. Results Among72 patients with GSVV, 70 patients were performed to endovenous RFA for GSVV without high ligation and they all received satisfactory recover after the operation with none suffering from severe complications such as deep venous thrombosis or pulmonary embolism.One month after surgery, all of GSVV following RFA were reviewed. Symptoms of affected extremities such as edema,pain,local acid bilges and numbness were obviously relieved or disappeared.No significant difference was observed in age,surgical extremity, grade of CEAP, time and velocity of reflux of affected extremities between male and female groups(P>0.05).The difference of the diameter of left GSVV between two groups was not significant(P>0.05). The difference in the diameter of right GSVV between two groups was significant(P<0.05). Conclusion CDFI can figure out whether a patient suffers from GSVV and help to choose the optimal treatment.It also guides the ongoing operation during the intraoperative time and assesses therapeutic effect after operation.Short-term effect of endovenous RFA without high ligation of GSVV is satisfactory,with none encountering sever complications.The diameter of right GSVV of female patients is narrower than that of male patients.更多还原