静脉腔内激光联合羟苯磺酸钙对下肢大隐静脉曲张患者预后的影响

吴成稳; 康海涵; 李飞; 张秀丽

doi:10.16766/j.cnki.issn.1674-4152.002847

静脉腔内激光联合羟苯磺酸钙对下肢大隐静脉曲张患者预后的影响

doi: 10.16766/j.cnki.issn.1674-4152.002847

1.
郑州大学第二附属医院血管外科，河南郑州 450014
2.
郑州大学第一附属医院血管外科，河南郑州 450000

基金项目:

河南省医学科技攻关计划联合共建项目 LHGJ20190059

详细信息

通讯作者:
吴成稳，E-mail：fs79i9@163.com

中图分类号: R543.6
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- 被引次数: 0
出版历程
- 收稿日期: 2022-03-08
- 网络出版日期: 2023-04-20

Effect of itravenously laser combined with calcium oxybenzenesulfonate in patients of lower limb varicose great saphenous vein

1.
Department of Vascular Surgery, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450014, China

摘要

摘要: 目的探讨静脉腔内激光联合羟苯磺酸钙对下肢大隐静脉曲张患者临床症状、血流动力学、病情严重程度及并发症等的影响，为患者临床治疗提供参考。方法选取2019年5月—2020年11月郑州大学第二附属医院收治的86例下肢大隐静脉曲张患者，采用随机数字表法分为对照组和观察组，每组各43例。记录患者手术时间、术中出血量、切口长度和住院时间，记录患者手术前后心率、血氧饱和度(SpO₂)、平均动脉压(MAP)、浅静脉血流速度和临床症状评分，采用静脉临床严重程度评分(VCSS)、阿伯丁静脉曲张问卷(AVVQ)对患者进行评估，记录术后并发症发生情况。结果观察组患者手术时间、术中出血量、切口长度、住院时间、酸胀疼痛、下肢肿胀、色素沉着、下肢溃疡等临床症状评分均低于对照组(均P＜0.05)。观察组术后心率[(75.26±10.85)次/min]、浅静脉血流速度[(2.23±0.69)cm/s]、VCSS评分[(7.46±3.64)分]、AVVQ评分[(6.82±3.41)分]和术后总并发症发生率[16.28%(7/36)]均低于对照组[(80.92±10.34)次/min、(2.74±0.95)cm/s、(9.72±3.57)分、(10.05±4.62)分、37.21%(16/36)，均P＜0.05]，MAP[(95.48±8.65)mm Hg, 1 mm Hg=0.133 kPa]高于对照组[(91.47±8.97)mm Hg, P＜0.05]。结论静脉腔内激光联合羟苯磺酸钙可减少血流动力学影响，改善下肢大隐静脉曲张患者临床症状，降低术后并发症发生率。
- 下肢大隐静脉曲张 /
- 静脉腔内激光 /
- 羟苯磺酸钙 /
- 血流动力学
Abstract: Objective To investigate the therapeutic effect of intravenous laser combined with calcium dobesilate on patients with varicose veins of lower extremities, and to provide reference for clinical treatment. Methods A total of 86 patients with varicose veins of the lower extremities who were admitted to the Second Affiliated Hospital of Zhengzhou University from May 2019 to November 2020 were enrolled in the study. The patients were divided into control and observation groups by using random number table method, with 43 cases in each group. Operation time, intraoperative blood loss, incision length and hospital stay were recorded. Heart rate, blood oxygen saturation (SpO₂), mean arterial pressure (MAP) and superficial vein blood flow velocity were recorded before and after surgery. The clinical severity of veins (VCSS) and Aberdeen varicose questionnaire (AVVQ) were used to evaluate the patients. The occurrence of postoperative complications was also recorded. Results The operation time, intraoperative blood loss, incision length, hospital stay, soreness and pain score, lower extremity swelling score, pigmentation score and lower extremity ulcer score of the observation group were lower than those in the control group (all P < 0.05). The postoperative heart rate [(75.26±10.85) times /min], superficial venous blood flow velocity [(2.23±0.69) cm/s], VCSS score [(7.46±3.64) points], AVVQ score [(6.82±3.41) points] and postoperative complication rate (16.28%, 7/36) of the observation group were lower than those in the control group [(80.92±10.34) times/min, (2.74±0.95) cm/s, (9.72±3.57) points, (10.05±4.62) points, 37.21% (16/36), all P < 0.05], and MAP [(95.48±8.65) mm Hg] was higher than that in the control group [(91.47±8.97) mm Hg, P < 0.05]. Conclusion Intravenous laser combined with calcium dobesilate can reduce haemodynamic effects, improve the clinical symptoms of patients of lower limb varicose great saphenous vein and reduce postoperative complications.
- Varicose veins of the lower extremities /
- Intravenous laser /
- Calcium dobesilate /
- Hemodynamics

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表 1 2组下肢大隐静脉曲张患者手术情况比较(x±s)

Table 1. Comparison of operation between two groups of patients with varicose veins in lower extremities (x±s)

组别	例数	手术时间 (min)	术中出血量 (mL)	切口长度 (cm)	住院时间 (d)
对照组	43	169.73±26.84	37.46±6.57	3.64±0.84	13.87±2.65
观察组	43	106.54±24.16	10.38±4.95	1.25±0.34	8.46±1.34
t值		11.474	21.587	17.294	11.947
P值		＜0.001	＜0.001	＜0.001	＜0.001

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表 2 2组下肢大隐静脉曲张患者血流动力学指标比较(x±s)

Table 2. Comparison of hemodynamic indexes between two groups of patients with varicose veins in lower extremities (x±s)

组别	例数	心率(次/min)		SpO₂(%)		MAP(mm Hg)		浅静脉血流速度(cm/s)
组别	例数	术前	术后	术前	术后	术前	术后	术前	术后
对照组	43	66.74±9.46	80.92±10.34^a	98.63±10.34	98.74±10.84	106.87±11.54	91.47±8.97^a	3.78±1.13	2.74±0.95^a
观察组	43	67.59±8.94	75.26±10.85^a	97.94±11.03	98.96±10.54	107.96±11.36	95.48±8.65^a	3.85±1.12	2.23±0.69^a
t值		0.428	2.476	0.299	0.095	0.441	2.110	0.289	2.848
P值		0.670	0.015	0.765	0.924	0.660	0.038	0.774	0.006
注：与同组术前比较，^aP＜0.05。1 mm Hg=0.133 kPa。

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表 3 2组下肢大隐静脉曲张患者VCSS、AVVQ评分比较(x±s, 分)

Table 3. Comparison of VCSS and AVVQ scores between two groups of patients with varicose veins in lower extremities (x±s, points)

组别	例数	VCSS		AVQQ
组别	例数	术前	术后	术前	术后
对照组	43	19.83±5.84	9.72±1.36^a	16.72±5.42	10.05±1.57^a
观察组	43	19.56±5.73	7.46±1.07^a	17.65±5.61	6.82±1.02^a
t值		0.216	7.836	0.782	10.351
P值		0.829	＜0.001	0.437	＜0.001
注：与同组术前比较，^aP＜0.05。

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表 4 2组下肢大隐静脉曲张患者症状改善情况比较(x±s, 分)

Table 4. Comparison of symptom improvement of lower limb varicose veins between two groups (x±s, points)

组别	例数	酸胀疼痛		下肢肿胀		色素沉着		下肢溃疡
组别	例数	术前	术后	术前	术后	术前	术后	术前	术后
对照组	43	9.53±0.42	7.81±1.57^a	8.69±1.13	6.21±0.68^a	8.72±1.05	6.59±0.52^a	8.67±1.24	6.83±0.67^a
观察组	43	9.48±0.21	5.26±1.35^a	8.95±1.25	4.82±0.54^a	8.69±1.21	4.28±0.63^a	8.72±1.14	4.51±0.43^a
t值		0.698	8.076	1.013	10.497	0.123	18.543	0.195	19.109
P值		0.487	＜0.001	0.315	＜0.001	0.903	＜0.001	0.846	＜0.001
注：与同组术前比较，^aP＜0.05。

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表 5 2组下肢大隐静脉曲张患者并发症发生率比较[例(%)]

Table 5. Comparison of complication rate between two groups of patients with varicose veins in lower extremities [cases (%)]

组别	例数	发热	皮下血肿	静脉血栓	切口感染	总发生
对照组	43	7(16.28)	4(9.30)	1(2.33)	4(9.30)	16(37.21)
观察组	43	3(6.98)	2(4.65)	0	2(4.65)	7(16.28)
注：2组总并发症发生率比较，χ²=4.807，P=0.028。

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