【摘要】 目的 比较腔内射频消融术（RFA）、腔内激光消融术（EVLA）、腔内微波消融术（EMA）和Havst导管剥脱术治疗大隐静脉曲张的近期疗效。方法 收集2019年1月至2020年11月南阳市中心医院收治的423例大隐静脉曲张患者的临床资料，根据手术方式的不同将其分为RFA组（n=132）、EVLA组（n=98）、EMA组（n=106）、Havst组（n=87），比较4组患者的临床指标、疼痛程度、生活质量评分。结果 4组患者术后1个月大隐静脉再通率、并发症发生率比较，差异均无统计学意义（P>0.05）。4组患者手术时间、恢复正常工作时间比较，差异均有统计学意义（P<0.05），其中，Havst组患者手术时间、恢复正常工作时间均较长。术后第1～7天，4组患者的视觉模拟评分法（VAS）评分比较，差异均有统计学意义（P<0.05），其中，RFA组VAS评分较低。术前、术后6个月，4组患者阿伯丁静脉曲张问卷（AVVQ）评分比较，差异均无统计学意义（P>0.05）；术后6个月，4组患者AVVQ评分均明显低于本组术前，差异均有统计学意义（P<0.05）。术后6个月，4组患者36条目健康调查简表（SF-36）中一般健康状况（GH）、生理功能（PF）、生理职能（RP）、躯体疼痛（BP）、精力（VT）、社会功能（SF）评分均高于本组术前，仅EVLA组患者情感职能（RE）和精神健康（MH）评分高于本组术前，差异均有统计学意义（P<0.05）。结论 4种微创手术方式均安全有效，患者近期生活质量均显著改善。更多还原

【Abstract】 Objective To compare the short-term efficacy of endovenous radiofrequency ablation(RFA), endovenous laser ablation(EVLA), endovenous microwave ablation(EMA), and Havst catheter stripping in the treatment of great saphenous varicose vein of lower extremity. Method The clinical data of 423 patients with great saphenous varicose vein admitted to Nanyang Central Hospital from January 2019 to November 2020 were collected. They were divided into the RFA group(n=132), EVLA group(n=98), EMA group(n=106), and Havst group(n=87) according to different surgical methods. The clinical indicators, pain degree, and quality of life scores of the four groups were compared.Result There were no significant differences in the great saphenous vein recanalization rate and the incidence rate of complications among the four groups at 1 and 6 months after the operation(P>0.05). There were statistically significant differences in the operation time and recovery time of the four groups of patients(P<0.05), among them, the operation time and recovery time of the patients in Havst group were longer. On the 1st to 7th day after the operation, the visual analogue scale(VAS) scores of the four groups were compared, the differences were statistically significant(P<0.05),among them, the VAS score of patients in the RFA group was the lowest. Before the operation and 6 months after the operation, there were no significant differences in Aberdeen varicose vein questionnaire(AVVQ) scores among the four groups(P>0.05). Six months after the operation, there were statistically significant differences in AVVQ scores among the four groups(P<0.05). Six months after the operation, the 36-item health survey short form(SF-36) of the four groups of patients with general health status(GH), physical functioning(PF), role-physical(RP), bodily pain(BP), vitality(VT), social functioning(SF) scores were higher than those before operation in the same group, but only the scores of role-emotional(RE) and mental health(MH) of patients in EVLA group were higher than those before operation in the same group, the differences were statistically significant(P<0.05). Conclusion The four minimally invasive surgical methods are safe and effective, and the short-term effect is similar.更多还原