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目的探讨冷光源引导下泡沫硬化剂注射小腿曲张浅静脉联合腔镜深筋膜下交通支静脉离断术(SEPS)及大隐静脉高位结扎抽剥术治疗下肢交通静脉功能不全所致的静脉溃疡中的作用效果。方法选取2012年6月至2013年5月就诊的42例(46条患肢)小腿交通静脉功能不全合并浅静脉曲张的静脉溃疡患者,行SEPS术及大隐静脉高位结扎抽剥术,并在SEPS术的冷光源引导下行小腿曲张静脉泡沫硬化剂注射术。结果共注射263条曲张浅表静脉。随访期间所有患者静脉溃疡均愈合。9例患者的9条下肢(9/46,19.57%)在术后4周内出现局部疼痛,口服止疼药可缓解。22例患者的24条下肢(24/46,52.17%)共46条静脉(46/263,17.49%)在术后1~2周出现沿治疗曲张静脉行程的黄褐色色素沉着,于3~6个月内自行消失。3例患者3条下肢(3/46,6.52%)共11条静脉(11/263,4.18%)在治疗后1周出现沿曲张静脉分布的红、热、痛和压痛,诊断为浅表性静脉炎,外用多磺酸黏多糖乳膏后缓解。经过注射的263条曲张静脉中,245条(245/263,93.16%)达到治疗成功标准,18条(18/263,6.84%)达到部分成功标准,无一条静脉未成功注射。结论冷光源引导下的小腿曲张静脉泡沫硬化剂注射联合SEPS术及大隐静脉高位结扎抽剥术是良好的治疗交通静脉功能不全所致静脉溃疡的方法,其长期作用效果有待进一步观察。
Objective To investigate the effect of cold light-source foam sclerosing agent injection varicose veins superficial varicose veins and endoscopic deep subfascial traffic branch vein grafting (SEPS) and high saphenous vein ligation and stripping on the treatment of venous insufficiency caused by venous insufficiency of lower limbs In the role of effect. Methods Forty-two patients (46 limbs) with venous insufficiency of varicose veins and superficial varicose veins treated during June 2012 to May 2013 were treated with SEPS and saphenous vein ligation and stripping The cold light source of SEPS guided the descending calf varicose vein sclerotherapy. Results A total of 263 superficial varicose veins were injected. All patients had venous ulcers healing during follow-up. Nine of 9 patients (9/46, 19.57%) developed local pain within 4 weeks after operation and oral pain relievers were relieved. A total of 46 veins (46 / 263,17.49%) of 24 limbs (24/46, 52.17%) of 22 patients showed yellowish brown pigmentation along the course of varicose veins 1 to 2 weeks after operation. Disappear within a month. A total of 11 venules (11/263 and 4.18%) of 3 lower limbs (3 / 46,6.52%) showed red, hot, pain and tenderness along the varicose veins in 1 week after treatment, which were diagnosed as superficial Phlebitis, topical mucopolysaccharide cream relief. Among 263 varicose veins injected, 245 (245 / 263,93.16%) reached the standard of treatment success, 18 of them (18 / 263,6.84%) met some of the success criteria, and none of the veins were unsuccessfully injected. Conclusion Cold light source guided calf varicose vein sclerosing agent injection combined with SEPS and saphenous vein ligation and stripping is a good method of treating venous ulcer caused by traffic insufficiency. The long-term effect remains to be further observed.