【作者】 陈洪； 潘海龙；

【机构】 浙江省杭州市萧山第一人民医院血管外科；

【摘要】 目的通过与传统的大隐静脉高位结扎、浅静脉剥脱术相比,论证激光治疗大隐静脉曲张的可行性及其疗效。方法选择进口激光治疗仪对我科2006年9月至2007年4月的75例患者施行激光治疗,所选病例均为 CEAPⅢ以下,谨慎选择适应症;腹股沟小切口高位离断大隐静脉,内踝上方穿刺大隐静脉主干,经导丝交换导管,置入激光光纤,确认在主干内,设定好功率,开启激光,边烧边退,间隔1cm,同时沿途压迫,使静脉腔闭合,分支亦予以烧灼,烧灼完毕后,弹力绷带加压包扎。术后两天出院,2周后解除弹力绷带,配弹力袜3～6个月。结果 75例患者无短期术后并发症发生,单侧肢体平均手术时间35min; 术后随访6～12个月,尚无复发。结论大隐静脉的激光治疗对大隐静脉曲张主干型且分支曲张病情较轻者,效果良好,但其远期疗效尚待有进一步观察。更多还原

【Abstract】 Objective Discuss the feasibility and therapeutic effect of endovenous laser treatment(EVLT)for varicose vein of lower extremity by contrasting with traditional high ligation and stripping of the great saphenous vein.Methods We selected the EVLT to treat 75patients in our department by using laser treatment instrument.We chose the patients with venous trunk type which are not serious(CEAP Ⅲ).After epidural anesthesia or lumbar anesthesia we stick through the trunk of great saphenous vein superior the medial malleolus.lnsert the guide wire upward,then insert the vessel along the guide wire,then withdraw the guide wire and insert fiber through vessel.First you must onfirm that the laser fiber is in the venous trunk,then turn on the laser,enactment power,pull the fiber and cauterize at the same time while the assistant press the leg along the great saphenous vien to make the lumen of vein occlusion.It maybe last 60～90s.After the operation we use pressure bandages to make a pressure dressing.At the third day after the operation patient can leave the hospital.Pressure bandages can be taken off after two weeks,then dressing compression socks for 6～12 months.Results The75 patients did not have short-term complication after the operation.Average surgery time is 35 minutes in single leg;After operation we made a follow-up for 6～12 months,The most effects are good.Conclusion EVLT effertive treatment to patients with venous trunk type and ramus varicose vein is not serious,but its prospecdtive efficacy need further observation.更多还原