【摘要】 目的 探讨泡沫硬化剂作为辅助用药在环形激光治疗大隐静脉曲张中的临床疗效。方法 回顾性分析太原市中心医院心脏大血管外科2019年1月至2020年12月采用1 470 nm环形激光联合泡沫硬化剂和点式剥脱治疗下肢静脉曲张的临床资料，观察并记录患者手术治疗情况和随访结果。结果 纳入87例患者（121条肢体），其中男性52例（60%），年龄30～84岁，平均（58±12）岁。术前临床表现-病因学-解剖学-病理生理学（CEAP）分级：C2为29例（33%）,C3为15例（17%）,C4为27例（31%）,C5为6例（7%）,C6为10例（11%）。手术成功率97.5%(118/121)。术后皮下淤斑发生率为11.9%(14/118)，术后1个月复查均消失；血栓性静脉炎发生率为3.4%(4/118)，给予消肿、活血、硫酸镁外敷等治疗后治愈；术后下肢深静脉血栓血栓发生率为3.4%(3/118)，其中2例无明显症状，1例表现为下肢肿胀，3例均给予3个月抗凝治疗，治疗1周后症状明显缓解。随访时间14～31个月，平均（22±4）个月。2条（1.7%）分别在术后1、6个月复查发现主干部分复通，再次给予手术处理。膝下12条（10.2%）在术后1个月复查有分支残留与复通，再次给予硬化剂或者局部麻醉下局部剥脱处理后消失。结论 在局部麻醉下，1 470 nm环形激光联合泡沫硬化剂治疗大隐静脉曲张是一种安全、有效的治疗方法。更多还原

【Abstract】 Objective To investigate the clinical efficacy of annular-beam laser ablation com-bined with foam sclerotherapy in treatment of great saphenous vein varicosis. Methods A retrospective analysis was performed on the clinical data of patients with lower extremity vein varicosis treated by 1 470 nm annular-beam laser ablation combined with foam sclerotherapy and punctate stripping in the Department of Cardiovascular Surgery,Taiyuan Central Hospital between January 2019 and December 2020. The surgical out-comes and follow-up of the patients were observed and recorded. Results Eighty-seven patients(121 limbs) in-cluding 52 males(60%) were recruited, aged 30-84 years old with a mean of(58±12) years. According to preoper-ative Clinical, Etiology,Anatomy and Pathophysiology(CEAP) classification, there were 29 patients wih CEAP class 2(33%), 15 with class 3(17%), 27 with class 4(31%), 6 with class 5(7%), and 10 with class 6(11%). The success rate of opera-tion was 97.5%(118/121). The incidence of subcutaneous ecchymosis after surgery was 11.9%(14/118), which disappeared in 1 month afterwards. The incidence of thrombophlebitis was 3.4%(4/118), which was cured after re-lieving the edema, promoting blood supply, and external use of magnesium sulfate. The incidence of postoperative deep vein thrombosis in lower limbs was 3%(3/118), with 2 patients staying largely asymptomatic and 1 presenting with lower limbs swelling. All 3 patients were treated on anticoagulants for 3 months, with significant relief in symptoms at 1 week of the treatment. The follow-up duration was 14～31 months, with a mean of(22±4) months. At1 and 6 months after surgery, respectively, 2 veins(1.7%) presented partial re-canalization at the main trunk and were subjected to re-do surgery. Twelve veins(10.2%) presented remnants and recanalization of venous branches below-knee at 1 month after surgery, which was resolved after an additional foam sclerotherapy or locally punctate stripping with topical anesthesia. Conclusion 1 470 nm annular-beam laser ablation combined with foam sclerotherapy and punctate stripping in treatment of great saphenous vein vari-cosis under topical anesthesia can be a safe and effective option of minimally invasive treatments for great saphe-nous vein varicosis.更多还原