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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (01) : 22 -25. doi: 10.3877/cma.j.issn.1674-0793.2015.01.006

所属专题： 文献；

论著

冷光源引导下泡沫硬化剂注射小腿曲张浅静脉在下肢静脉溃疡治疗中的应用探讨
龙淼云1, 罗定远1, 彭新治1, 黄楷1, 黄明清1, 林少建1, 黎洪浩1,†()   
  1. 1. 510120　广州，中山大学孙逸仙纪念医院血管外科
  • 收稿日期:2013-11-04 出版日期:2015-02-01
  • 通信作者: 黎洪浩

Clinical efficacy of cold light source-guided foam sclerotherapy with lauromacrogol for venous ulcer of the lower extremities

Miaoyun Long1, Dingyuan Luo1, Xinzhi Peng1, Kai Huang1, Mingqing Huang1, Shaojian Lin1, Honghao Li1,†()   

  1. 1. Department of Vascular Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China
  • Received:2013-11-04 Published:2015-02-01
  • Corresponding author: Honghao Li
  • About author:
    Corresponding author: Li Honghao, Email:
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龙淼云, 罗定远, 彭新治, 黄楷, 黄明清, 林少建, 黎洪浩. 冷光源引导下泡沫硬化剂注射小腿曲张浅静脉在下肢静脉溃疡治疗中的应用探讨[J]. 中华普通外科学文献(电子版), 2015, 09(01): 22-25.

Miaoyun Long, Dingyuan Luo, Xinzhi Peng, Kai Huang, Mingqing Huang, Shaojian Lin, Honghao Li. Clinical efficacy of cold light source-guided foam sclerotherapy with lauromacrogol for venous ulcer of the lower extremities[J]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(01): 22-25.

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。

关键词: 静脉溃疡, 泡沫硬化剂, 冷光源
Objective

To observe the clinical efficacy of cold light source-guided foam sclerotherapy with lauromacrogol combining subfascial endoscopic perforator surgery(SEPS) and long saphenous vein flush ligation and stripping for venous ulcer of the lower extremities.

Methods

From June 2012 to May 2013, forty-two patients with forty-six lower limbs of venous ulcer induced by incompetent perforator veins were treated. All the patients were performed SEPS, long saphenous vein flush ligation and stripping, and cold light source-guided foam sclerotherapy with lauromacrogol.

Results

Foam was injected to 263 veins by cold light-guided source. All venous ulcers were found recovered from a 3- to 12-month followed up. Nine patients felt pain in lower limbs and were given painkillers. Forty-six veins(17.49%) of 22 patients showed pigmentation following the varicosities one to two weeks after surgery. It disappeared in 3-6 months. Eleven veins (4.18%) of 3 lower extremities (6.52%) of 3 patients with varicosities demonstrated phlebitis and recovered after using Hirudoid. Two hundred and forty-five veins(93.16%) of treated varicosities achieved complete success criteria; the other 18 veins (6.84%) achieved partial success criteria.

Conclusion

Cold light source-guided foam sclerotherapy with lauromacrogol combining SEPS and long saphenous vein flush ligation and stripping is a good method to treat venous ulcer of the lower extremities, while the long-term effects need observing.

Key words: Venous ulcer, Foam sclerotherapy, Cold light source-guided
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