摘要
目的探讨射频消融术联合聚多卡醇泡沫硬化剂治疗对下肢静脉曲张术后深静脉血栓(DVT)形成的影响。方法回顾性分析2021年12月至2024年12月天津市人民医院收治的150例(185患肢)下肢静脉曲张患者的病历资料,根据治疗方式不同分为研究组(n=73,90患肢)和对照组(n=77,95患肢),对照组采用聚多卡醇泡沫硬化剂治疗,研究组采用射频消融术联合聚多卡醇泡沫硬化剂治疗。比较两组患者围手术期指标、凝血指标(D-二聚体、纤维蛋白原)、术后下肢静脉超声情况、术后并发症及术后随访情况。结果研究组患者手术时间长于对照组[(1.38±0.40)h比(1.12±0.21)h](P<0.01),但住院时间短于对照组[(5.9±1.5)d比(7.3±2.5)d](P<0.01),两组患者术中出血量比较差异无统计学意义(P>0.05)。术后3d,两组患者D-二聚体、纤维蛋白原水平均升高(P<0.05),但两组间D-二聚体、纤维蛋白原水平比较差异无统计学意义(P>0.05)。两组患者肌间静脉血栓形成发生率比较差异无统计学意义(P>0.05)。术后研究组血栓性浅静脉炎发生率低于对照组[0比6.32%(6/95)](P<0.05)。术后3个月,两组患者血栓性静脉炎发生率比较差异无统计学意义(P>0.05)。术后6个月,两组患者静脉曲张复发率比较差异无统计学意义(P>0.05)。结论虽然射频消融术联合聚多卡醇泡沫硬化剂治疗下肢静脉曲张延长了手术时间,对凝血功能及DVT形成无明显影响,但能缩短恢复时长,且可有效降低术后血栓性浅静脉炎的发生风险。
Objective To investigate the effect of radiofrequency ablation combined with polidocanol foam sclerotherapy for varicose veins of lower limbs on the postoperative deep venous thrombosis(DVT).MethodsA retrospective analysis was conducted on the medical records of 150 patients(185 affected limbs)with lower extremity varicose veins admitted to Tianjin People's Hospital from Dec.2021 to Dec.2024.The patients were divided into a study group(n=73,90 affected limbs)and a control group(n=77,95 affected limbs)based on their treatment methods.The control group was treated with polydocanol foam sclerotherapy,while the study group was treated with radiofrequency ablation and polydocanol foam sclero therapy.The perioperative indicators,coagulation indicators(D-dimer and fibrinogen),postoperative lower limb venous ultra sound conditions,postoperative complications and postoperative follow-up of the two groups were compared.Results The operation time in the study group was longer than that in the control group[(1.38±0.40)h vs(1.12±0.21)h](P<0.01),but the length of hospitalization was shorter than that in the control group[(5.9±1.5)d vs(7.3±2.5)d](P<0.01).The difference of intraoperative blood loss was not significant between the two groups(P>0.05).Three days after the operation,the levels of D-dimer and fibrinogen in both groups increased on average(P<0.05),but there was no statistically significant difference in the levels of D-dimer and fibrinogen between the two groups(P>0.05).There was no significant difference in the incidence of intermuscular vein thrombosis between the two groups(P>0.05).The incidence of superficial thrombophlebitis in the study group was significantly lower than that in the control group[0vs 6.32%(6/95)](P<0.05).At 3 months after surgery,there was no significant difference in the incidence of thrombophlebitis between the two groups(P>0.05).At 6 months after surgery,there was no significant difference in the recurrence rate of varicose veins between the two groups(P>0.05).Conclusion Although radiofrequency ablation combined with polidocanol foam sclerotherapy for lower limb varicose veins prolongs the operation time,it has no significant effect on coagulation function and DVT formation,and can shorten the recovery time and effectively reduce the risk of postoperative superficial thrombophlebitis.
作者
郑鹏远
穆永亮
ZHENG Pengyuan;MU Yongliang(Department of Vascular Surgery,Tianjin People's Hospital/the First Affiliated Hospital of Nankai University,Tianjin 300121,China)
出处
《医学综述》
2025年第21期2745-2749,共5页
Medical Recapitulate
关键词
下肢静脉曲张
射频消融术
聚多卡醇泡沫硬化剂
深静脉血栓
超声
Varicose veins of lower limbs
Radiofrequency ablation
Polidocanol foam sclerotherapy
Deep vein throm-bosis
Ultrasound
