透光直视旋切术与腔镜深筋膜下结扎交通支静脉在静脉性溃疡治疗中的疗效比较研究

目的比较透光直视旋切术(TriVex)与腔镜深筋膜下结扎交通支静脉(SEPS)治疗静脉溃疡的效果。方法将我院在2009年1月至2011年6月间收治的静脉溃疡患者根据住院单双号分为TriVex组和SEPS组。TriVex组行大隐静脉高位结扎、抽剥和TriVex静脉旋切系统旋切术,对溃疡周围浅静脉予完全刨除;SEPS组行大隐静脉高位结扎、抽剥和腔镜深筋膜下结扎交通支静脉,对小腿曲张静脉及溃疡周围静脉行点状抽剥术。比较两组患者在溃疡愈合率、愈合时间及术后溃疡复发率的差异。结果两组患者的溃疡愈合率、愈合时间及溃疡复发率比较,差异无统计学意义(P>0.05),且均未发生深静脉血栓形成等严重并发症,但SEPS组术后皮下淤血或局部皮肤麻木感等轻微并发症高于TriVex组,而患者满意率低于TriVex组,两组差异有统计学意义(P<0.05)。结论 TriVex和SEPS均可有效治疗静脉溃疡,但SEPS可能会出现更多的皮下淤血或局部皮肤麻木感等轻微并发症,患者对TriVex的满意度更高。

Comparative study of the efficacy of venous ulcer in lower extremity treated by transilluminated powered phlebectomy and subfascial endoscopic perforator surgery

Objective To compare the effect of venous ulcer in lower extremity treated by transilluminated powered phlebectomy (TriVex) and subfascial endoscopic perforator surgery (SEPS). Methods Patients with venous ulcer in lower extremity treated in our hospital from January 2009 to June 2011 were divided into TriVex group and SEPS group by hospital number. Patients in TriVex group treated by TriVex system and great saphenous vein ligation and stripping, and varicose superficial veins surrounding ulcer were treated by TriVex system at the same time..Patients in SEPS groups were treated by SEPS, great saphenous vein ligation and stripping,and variocose superficial veins were treated by spot-striping. Ulcer healing rate, ulcer healing period and recurrence rate between both groups were compared. Results There were no statistically significant differences of ulcer heal rate, heal period and recurrence rate of venous ulcer in lower extremity in two groups (P>0.05). No deep venous thrombosis occurred in both groups,however, slight complications such as subcutaneous hematoma and skin numbness after operation were much higher in SEPS group than in TriVex group. The satisfaction rate of patients in SEPS group was lower than TriVex group(P<0.05). Conclusion TriVex system and SEPS are the effective methods in treating venous ulcer in lower extremity. However, slight complications rate after TriVex operation is much lower than SEPS group and satisfaction rate is lower in patients who treated by SEPS.