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 , 万恒 , 刘正军

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Keywords：

激光腔内闭合; 点式切除; 下肢静脉曲张

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目的观察激光腔内闭合联合点式切除治疗下肢静脉曲张的疗效。方法回顾性分析我科2007年5月至2011年1月期间采用激光腔内闭合联合点式切除治疗310例下肢静脉曲张患者的临床资料，其中男121例，女189例，共406条肢体; 平均年龄52.6岁。结果所有患者术后临床症状得到改善，术后第3天查彩超显示所有大隐静脉主干完全闭合。36例合并皮肤溃疡患者中25例术后经换药后溃疡面明显缩小，11例术后3个月溃疡面愈合。术后有110例出现不同程度患肢皮下瘀斑，15例出现大隐静脉行程的皮下血肿，未予特殊处理，术后2~3周后均自行好转。术后出现小腿中下段内侧皮肤麻木及感觉障碍118例，术后3个月均有不同程度好转。所有患者切口一期愈合，无切口感染，未出现皮肤烧灼伤及术后下肢深静脉血栓形成。平均住院时间6.3 d。结论激光腔内闭合联合点式切除是治疗下肢静脉曲张的微创、安全及有效的方法。

Citation： 林智琪,万恒,刘正军. 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. 腔内激光治疗下肢静脉曲张450例报告 [J]. 中国微创外科杂志, 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.	吕磊, 张纪蔚, 张柏根. 腔内激光综合传统手术治疗下肢静脉曲张的疗效分析 [J]. 中华外科杂志, 2008, 46(4): 316317.
11.	贾玉龙, 李娜, 汪岩, 等. 高位结扎联合腔内激光治疗大隐静脉曲张的临床分析 [J]. 首都医科大学学报, 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.	谭正力, 郁正亚. 下肢静脉曲张静脉腔内激光治疗参数设定分析 [J]. 中国实用外科杂志, 2009, 29(11): 941942.
14.	王志刚, 雷泽华, 余慎林. 静脉腔内激光和传统手术治疗下肢静脉曲张的近期疗效比较 [J]. 中国普外基础与临床杂志, 2010, 17(4): 372375.
15.	孙春亮, 李安富, 徐宪辉, 等. 腔内激光治疗大隐静脉曲张并发症的防治 [J]. 中国普通外科杂志, 2007, 16(6): 598599.
16.	禄韶英, 李安富, 徐宪辉, 等. 腔内激光治疗下肢浅静脉曲张并发症的探讨 [J]. 中华普通外科杂志, 2006, 21(9): 657659.
17.	陈学东, 王育红, 姜福亭, 等. 下肢静脉曲张疾病腔内激光治疗并发症的防治 [J]. 中国普通外科杂志, 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. 腔内激光治疗下肢静脉曲张450例报告 [J]. 中国微创外科杂志, 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. 吕磊, 张纪蔚, 张柏根. 腔内激光综合传统手术治疗下肢静脉曲张的疗效分析 [J]. 中华外科杂志, 2008, 46(4): 316317.
11. 贾玉龙, 李娜, 汪岩, 等. 高位结扎联合腔内激光治疗大隐静脉曲张的临床分析 [J]. 首都医科大学学报, 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. 谭正力, 郁正亚. 下肢静脉曲张静脉腔内激光治疗参数设定分析 [J]. 中国实用外科杂志, 2009, 29(11): 941942.
14. 王志刚, 雷泽华, 余慎林. 静脉腔内激光和传统手术治疗下肢静脉曲张的近期疗效比较 [J]. 中国普外基础与临床杂志, 2010, 17(4): 372375.
15. 孙春亮, 李安富, 徐宪辉, 等. 腔内激光治疗大隐静脉曲张并发症的防治 [J]. 中国普通外科杂志, 2007, 16(6): 598599.
16. 禄韶英, 李安富, 徐宪辉, 等. 腔内激光治疗下肢浅静脉曲张并发症的探讨 [J]. 中华普通外科杂志, 2006, 21(9): 657659.
17. 陈学东, 王育红, 姜福亭, 等. 下肢静脉曲张疾病腔内激光治疗并发症的防治 [J]. 中国普通外科杂志, 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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