隐股静脉瓣下大隐静脉结扎联合腔内激光术治疗下肢静脉曲张性溃疡

目的 探讨隐股静脉瓣下大隐静脉结扎联合腔内激光术（EVLT）治疗下肢静脉曲张性溃疡的疗效.方法 选择收治的70例（74条患肢）下肢静脉曲张性溃疡患者,随机分为观察组和对照组,每组各35例,观察组施行隐股静脉瓣下大隐静脉结扎联合EVLT术,对照组采用传统大隐静脉高位结扎联合点状静脉抽剥术,对比观察两组患者的疗效.结果 术后随访6～ 10个月,观察组治疗总有效率94.59％,对照组81.08％,观察组疗效优于对照组.观察组溃疡愈合时间、术后疼痛发生率、切口感染率及隐神经损伤发生率均显著低于对照组.皮肤坏死、踝部水肿消失发生率,两组差异无统计学意义（P＞0.05）.观察组溃疡复发率低于对照组（P＜0.05）.结论 隐股静脉瓣下大隐静脉结扎联合EVLT术治疗下肢静脉曲张性溃疡疗效显著,其操作简单、创伤小、恢复快、复发率低,优于传统术式,值得推广应用.

Endovenous laser treatment combined with great saphenous vein ligation below the saphenous-femoral vein valve for lower limb varicose ulcer

Objective To study the clinical effect of endovenous laser treatment （EVLT）com bined with great saphenous vein ligation below saphenous femoral vein valve for lower limb varicose ulcer.Methods A total of 70 cases （74 limbs）of the lower limb varicose ulcer were randomly divided into observation group and control group,with 35 cases in each group.Patients in the observation group were treated with great saphenous vein ligation below the saphenous-femoral vein valve combined with EVLT,and patients in the control group were treated with traditional great saphenous vein high ligation plus ambulato ry phlebectomy for varicose vein.Then clinical effects of the two groups were observed for comparison.Results After 6-10 months follow-up,total effectiveness of the observation group（94.59％）was higher than that of the control group（81.08％）.The ulcer healing time of the observation group was obviously shorter than that of the control group,as well as the significant lower incidence of postoperative pain,incision infection rate and saphenous nerve injury rate.There was no significant difference in the incidence of skin necrosis and ankle edema relief in the two groups （P ＞ 0.05）.Ulcer recurrence rate in the observation group is lower than that of the control group （P ＜ 0.05）.Conclusion In the treatment of lower limbs varicose ulcer,EVLT combined with ligation of great saphenous vein below saphenous femoral vein valve is obviously effective.It is superior to the traditional method for simple operation,minimal invasion,quick recovery and low recurrence rate,which is worth of popularization and application.