Clinical Evaluation of Endovenous Laser Treatment Associated with Pointed Phlebectomy for Varicose Veins of Lower Limbs_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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林智琪 , 萬恒 , 劉正軍

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Keywords：

激光腔內閉合; 點式切除; 下肢靜脈曲張

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目的觀察激光腔內閉合聯合點式切除治療下肢靜脈曲張的療效。方法回顧性分析我科2007年5月至2011年1月期間采用激光腔內閉合聯合點式切除治療310例下肢靜脈曲張患者的臨床資料，其中男121例，女189例，共406條肢體; 平均年齡52.6歲。結果所有患者術后臨床癥狀得到改善，術后第3天查彩超顯示所有大隱靜脈主干完全閉合。36例合并皮膚潰瘍患者中25例術后經換藥后潰瘍面明顯縮小，11例術后3個月潰瘍面愈合。術后有110例出現不同程度患肢皮下瘀斑，15例出現大隱靜脈行程的皮下血腫，未予特殊處理，術后2~3周后均自行好轉。術后出現小腿中下段內側皮膚麻木及感覺障礙118例，術后3個月均有不同程度好轉。所有患者切口一期愈合，無切口感染，未出現皮膚燒灼傷及術后下肢深靜脈血栓形成。平均住院時間6.3 d。結論激光腔內閉合聯合點式切除是治療下肢靜脈曲張的微創、安全及有效的方法。

Citation： 林智琪,萬恒,劉正軍. Clinical Evaluation of Endovenous Laser Treatment Associated with Pointed Phlebectomy for Varicose Veins of Lower Limbs. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 995-996. doi: Copy

1.	van den Bos RR, Kockaert MA, Neumann HA, et al. Technical review of endovenous laser therapy for varicose veins [J]. Eur J Vasc Endovasc Surg, 2008, 35(1): 8895.
2.	Brasic N, Lopresti D, McSwain H. Endovenous laser ablation and sclerotherapy for treatment of varicose veins [J]. Semin Cutan Med Surg, 2008, 27(4): 264275.
3.	Schmedt CG, Meissner OA, Hunger K, et al. Evaluation of endovenous radiofrequency ablation and laser therapy with endoluminal optical coherence tomography in an ex vivo model [J]. J Vasc Surg, 2007, 45(5): 10471058.
4.	Puggioni A, Kalra M, Carmo M, et al. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications [J]. J Vasc Surg, 2005, 42(3): 488493.
5.	Forrestal MD, Fronek HS, Isaacs MN, et al. Endovenous laser treatment [J]. Dermatol Surg, 2003, 29(3): 312313.
6.	Proebstle TM, Gül D, Kargl A, et al. Endovenous laser treatment of the lesser saphenous vein with a 940nm diode laser: early results [J]. Dermatol Surg, 2003, 29(4): 357361.
7.	梅家才, 汪昱, 伍波, 等. 腔內激光治療下肢靜脈曲張450例報告 [J]. 中國微創外科雜志, 2007, 7(7): 617618.
8.	Porter JM, Moneta GL. International consensus committee on chronic venous disease: reporting standards in venous disease: an update [J]. J Vasc Surg, 1995, 21(4): 635645.
9.	Rutherford RB, Padberg FT Jr, Comerota AJ, et al. Venous severity scoring: An adjunct to venous outcome assessment [J]. J Vasc Surg, 2000, 31(6): 13071312.
10.	呂磊, 張紀蔚, 張柏根. 腔內激光綜合傳統手術治療下肢靜脈曲張的療效分析 [J]. 中華外科雜志, 2008, 46(4): 316317.
11.	賈玉龍, 李娜, 汪巖, 等. 高位結扎聯合腔內激光治療大隱靜脈曲張的臨床分析 [J]. 首都醫科大學學報, 2007, 28(3): 399401.
12.	Theivacumar NS, Dellagrammaticas D, Beale RJ, et al. Factors influencing the effectiveness of endovenous laser ablation (EVLA) in the treatment of great saphenous vein reflux [J]. Eur J Vasc Endovasc Surg, 2008, 35(1): 119123.
13.	譚正力, 郁正亞. 下肢靜脈曲張靜脈腔內激光治療參數設定分析 [J]. 中國實用外科雜志, 2009, 29(11): 941942.
14.	王志剛, 雷澤華, 余慎林. 靜脈腔內激光和傳統手術治療下肢靜脈曲張的近期療效比較 [J]. 中國普外基礎與臨床雜志, 2010, 17(4): 372375.
15.	孫春亮, 李安富, 徐憲輝, 等. 腔內激光治療大隱靜脈曲張并發癥的防治 [J]. 中國普通外科雜志, 2007, 16(6): 598599.
16.	祿韶英, 李安富, 徐憲輝, 等. 腔內激光治療下肢淺靜脈曲張并發癥的探討 [J]. 中華普通外科雜志, 2006, 21(9): 657659.
17.	陳學東, 王育紅, 姜福亭, 等. 下肢靜脈曲張疾病腔內激光治療并發癥的防治 [J]. 中國普通外科雜志, 2006, 15(12): 935937.

1. van den Bos RR, Kockaert MA, Neumann HA, et al. Technical review of endovenous laser therapy for varicose veins [J]. Eur J Vasc Endovasc Surg, 2008, 35(1): 8895.
2. Brasic N, Lopresti D, McSwain H. Endovenous laser ablation and sclerotherapy for treatment of varicose veins [J]. Semin Cutan Med Surg, 2008, 27(4): 264275.
3. Schmedt CG, Meissner OA, Hunger K, et al. Evaluation of endovenous radiofrequency ablation and laser therapy with endoluminal optical coherence tomography in an ex vivo model [J]. J Vasc Surg, 2007, 45(5): 10471058.
4. Puggioni A, Kalra M, Carmo M, et al. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications [J]. J Vasc Surg, 2005, 42(3): 488493.
5. Forrestal MD, Fronek HS, Isaacs MN, et al. Endovenous laser treatment [J]. Dermatol Surg, 2003, 29(3): 312313.
6. Proebstle TM, Gül D, Kargl A, et al. Endovenous laser treatment of the lesser saphenous vein with a 940nm diode laser: early results [J]. Dermatol Surg, 2003, 29(4): 357361.
7. 梅家才, 汪昱, 伍波, 等. 腔內激光治療下肢靜脈曲張450例報告 [J]. 中國微創外科雜志, 2007, 7(7): 617618.
8. Porter JM, Moneta GL. International consensus committee on chronic venous disease: reporting standards in venous disease: an update [J]. J Vasc Surg, 1995, 21(4): 635645.
9. Rutherford RB, Padberg FT Jr, Comerota AJ, et al. Venous severity scoring: An adjunct to venous outcome assessment [J]. J Vasc Surg, 2000, 31(6): 13071312.
10. 呂磊, 張紀蔚, 張柏根. 腔內激光綜合傳統手術治療下肢靜脈曲張的療效分析 [J]. 中華外科雜志, 2008, 46(4): 316317.
11. 賈玉龍, 李娜, 汪巖, 等. 高位結扎聯合腔內激光治療大隱靜脈曲張的臨床分析 [J]. 首都醫科大學學報, 2007, 28(3): 399401.
12. Theivacumar NS, Dellagrammaticas D, Beale RJ, et al. Factors influencing the effectiveness of endovenous laser ablation (EVLA) in the treatment of great saphenous vein reflux [J]. Eur J Vasc Endovasc Surg, 2008, 35(1): 119123.
13. 譚正力, 郁正亞. 下肢靜脈曲張靜脈腔內激光治療參數設定分析 [J]. 中國實用外科雜志, 2009, 29(11): 941942.
14. 王志剛, 雷澤華, 余慎林. 靜脈腔內激光和傳統手術治療下肢靜脈曲張的近期療效比較 [J]. 中國普外基礎與臨床雜志, 2010, 17(4): 372375.
15. 孫春亮, 李安富, 徐憲輝, 等. 腔內激光治療大隱靜脈曲張并發癥的防治 [J]. 中國普通外科雜志, 2007, 16(6): 598599.
16. 祿韶英, 李安富, 徐憲輝, 等. 腔內激光治療下肢淺靜脈曲張并發癥的探討 [J]. 中華普通外科雜志, 2006, 21(9): 657659.
17. 陳學東, 王育紅, 姜福亭, 等. 下肢靜脈曲張疾病腔內激光治療并發癥的防治 [J]. 中國普通外科雜志, 2006, 15(12): 935937.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Evaluation of Endovenous Laser Treatment Associated with Pointed Phlebectomy for Varicose Veins of Lower Limbs

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