大隐静脉主干机械化学阻断术治疗静脉曲张的效果

О. Nejmatzoda, A. Gaibov, D. D. Sultanov, O. F. Soliev, H. A. Yunusov
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引用次数: 0

摘要

目的:评估机械化学阻断术治疗大隐静脉曲张扩张的有效性:对 57 名静脉曲张患者(49 名(85.9%)女性,8 名(14.1%)男性;平均年龄 27.2±4.1 岁)的机械化学阻塞治疗结果进行分析。在 39 名患者(36 名女性和 3 名男性)中观察到皮下静脉曲张的第二类转变,在 18 名患者(13 名女性和 5 名男性)中观察到皮下静脉曲张的第三类转变。患者的平均体重指数为 28.2±2.4 kg/m2,静脉曲张病程平均为 7.6±1.8 年:大隐静脉的平均直径为(10.4±2.1)毫米。31例(54.4%)患者发现穿孔静脉不足,平均直径为(3.2±0.8)毫米。手术的技术成功率为 100%。所有患者均未出现术中并发症。机械化学阻塞平均持续时间为(24.2±4.8)分钟,整个手术--横切、机械化学阻塞和切除扩张的支静脉--持续时间为(98.5±25.5)分钟。接受机械化学阻断的大隐静脉平均长度为 94.2±6.1 厘米。术后第一天的疼痛程度为 3.8±0.6 点,出院前降至 0.9±0.1 点。只有在手术后的第二天,患者需要使用麻醉镇痛药(麻醉药的平均用量为1.5±0.5毫升);在其他日子里,患者需要使用非甾体抗炎药(平均用药时间为3.5±0.5天,用药量为10.5±1.5毫升):机械-化学硬化剂清除术是消除病理性垂直反流的有效方法之一,绝大多数患者都能长期观察到其疗效,而且由于其微创性和重复应用的能力,可推荐在临床上广泛使用。为了提高机械化学阻断术的效果,减少大隐静脉再次闭塞的频率,有必要辅以交叉切除术和小隐静脉切除术。
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Results of mechano-chemical obliteration of the trunk of the great saphenous vein in varicose vein disease
Aim: To evaluate the effectiveness of mechano-chemical obliteration in the treatment of varicose enlargement of the great saphenous vein.Material and Methods: The results of mechano-chemical obliteration of 57 patients (49 (85.9%) women, 8 (14.1%) men; average age 27.2±4.1 years) with varicose disease were analyzed. In 39 patients (36 women and 3 men), the second, and in 18 (13 women and 5 men) – the third class of varicose transformation of subcutaneous veins was observed. The average body mass index of patients was 28.2±2.4 kg/m2, and the average duration of varicose disease was 7.6±1.8 years.Results and Discussion: The average diameter of the great saphenous vein was 10.4±2.1 mm. Insufficiency of perforating veins with an average diameter of 3.2±0.8 mm was detected in 31 (54.4%) cases. The technical success of the procedure was 100%. No intraoperative complications occurred in any patient. The average duration of mechanochemical obliteration was 24.2±4.8 minutes, and the entire operation – crossectomy, mechano-chemical obliteration, and excision of dilated tributary veins – lasted 98.5±25.5 minutes. The average length of the great saphenous vein subjected to mechano-chemical obliteration was 94.2±6.1 cm. The level of pain on the first day after surgery was 3.8±0.6 points, decreasing to 0.9±0.1 points before discharge. Only on the day after the intervention, patients required narcotic analgesics (average volume of used anesthetics – 1.5±0.5 ml); on other days, patients received non-steroidal anti-inflammatory drugs (average duration 3.5±0.5 days, volume – 10.5±1.5 ml).Conclusion: Mechano-chemical scleroobliteration is one of the effective methods for eliminating pathological vertical reflux, with its effectiveness observed in the vast majority of patients in the long term.Moreover, due to its minimal invasiveness and capability for repeated application, it can be recommended for widespread clinical use. To improve the results of mechano-chemical obliteration and reduce the frequency of recanalization of the great saphenous vein, it is necessary to supplement the procedure with crossectomy and miniphlebectomy.
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