1. 上海中医药大学附属曙光医院外七科,上海,201203
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YANG Xiao, LIU Guobin, YAN Shaoqing, et al. Clinical observation on effect of sclerosing foam combined with point-stage stripping on varicose veins of lower limbs under local anesthesia. [J]. Shanghai Journal of Traditional Chinese Medicine 53(3):56-59(2019)
YANG Xiao, LIU Guobin, YAN Shaoqing, et al. Clinical observation on effect of sclerosing foam combined with point-stage stripping on varicose veins of lower limbs under local anesthesia. [J]. Shanghai Journal of Traditional Chinese Medicine 53(3):56-59(2019) DOI: 10.16305/j.1007-1334.2019.03.014.
目的:观察局麻下(府舍穴注射麻醉)泡沫硬化剂联合点段式剥脱术治疗下肢静脉曲张的临床疗效。 方法:将100例下肢静脉曲张患者随机分为治疗组和对照组,每组50例,治疗组予府舍穴局部注射麻醉下泡沫硬化剂联合点段式剥脱术治疗,对照组予腰麻下大隐静脉高位结扎联合抽剥术治疗。术后定期随访1年,观察临床疗效及复发情况,比较术中指标(出血量、手术时间)、住院天数及术后不良反应(恶心呕吐、尿潴留、肢体麻木)、并发症(创面感染、瘀斑或血肿、疼痛)等情况。 结果:①治疗组、对照组治愈率分别为96.0%、98.0%;组间临床疗效比较,差异无统计学意义(P>0.05)。②组间出血量、住院时间比较,治疗组明显少于对照组(P<0.05)。组间手术时间比较,差异无统计学意义(P>0.05)。③治疗组术后恢复良好,没有患者出现恶心呕吐、尿潴留、肢体麻木等术后反应。对照组术后恢复尚可,有10例患者出现恶心呕吐、尿潴留、肢体麻木等术后反应。④组间术后并发症比较,治疗组在创面感染、瘀斑或血肿、疼痛方面,均明显少于对照组(P<0.05)。⑤随访期治疗组复发1例、对照组复发8例,组间复发率比较差异有统计学意义,治疗组明显低于对照组(P<0.05)。 结论:相较传统腰麻下大隐静脉高位结扎联合抽剥术,局麻下(府舍穴注射麻醉)泡沫硬化剂联合点段式剥脱治疗下肢静脉曲张,具有术中出血量少、住院时间短,术后不良反应少、创面感染少、疼痛少、复发率低等优势。
Objective:To investigate the clinical efficacy of sclerosing foam combined with point-stage stripping in the treatment of varicose veins of the lower limbs under local anesthesia by Fushe acupoint injection. Methods100 patients with varicose veins of the lower limbs were randomly assigned into treatment group and control group, 50 patients in each group. The treatment group was given sclerosing foam combined with point-stage stripping under local anesthesia by Fushe acupoint injection and the control group received high ligation of the great saphenous vein combined with stripping under lumbar anesthesia. Regular follow-up was performed for a year after operation. Clinical efficacy and relapse were observed, and intraoperative measures (blood loss and operation duration), duration of hospitalization (days) and postoperative adverse reactions (nausea and vomiting, urinary retention and limb numbness) and complications (wound infection, ecchymosis or hematoma and pain) were compared. Results:①The cure rate was 96.0% and 98.0% in the treatment and control groups, respectively with no significant difference between the groups (P<0.05). ②Blood loss and duration of hospitalization decreased significantly in the treatment group compared to the control group (P<0.05). There was no statistically significant difference in operation duration between the groups (P>0.05). ③Good post-operative recovery was seen in the treatment group, with no patients showing post-operative reactions including nausea, vomiting, urinary retention or limb numbness. Acceptable recovery was seen in the control group, with 10 patients showing the post-operative reactions mentioned above. ④In terms of post-operative complications, there was significant decrease in wound infection, ecchymosis or hematoma and pain in the treatment group than in the control group (P<0.05). ⑤1 and 8 patients had relapse in the treatment and control groups respectively during follow-up, and the relapse rate was significantly lower in the treatment group than in the control group (P<0.05). Conclusion:Compared with high ligation of the great saphenous vein combined with stripping under traditional lumbar anesthesia, sclerosing foam combined with point-stage stripping under local anesthesia by Fushe acupoint injection shows advantages in the treatment of varicose veins, including decreased blood loss, shorter duration of hospitalization, less postoperative complications, decreased wound infections, less pain and lower relapse rate.
府舍穴注射麻醉下肢静脉曲张点段式剥脱术泡沫硬化剂
Fushe acupointinjection anesthesiavaricose veinspoint-stage strippingsclerosing foam
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