对腿部静脉溃疡患者进行两种消融术联合高位结扎和泡沫硬化剂疗法及压力疗法的比较。

Postgraduate medicine Pub Date : 2024-06-01 Epub Date: 2024-06-13 DOI:10.1080/00325481.2024.2366155
Guofu Zheng, Hailiang Xie, Minggui Lai, Bao Qin, Xiaochun Liu
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引用次数: 0

摘要

目的:比较静脉腔内微波消融术(EMA)联合高位结扎术(HL)、泡沫硬化剂注射术(FS)和压迫疗法(CT)以及静脉腔内激光消融术(EVLA)联合HL-FS-CT治疗VLU的疗效:方法:对一家拥有3200张床位的医院从2013年至2022年连续接受EMA联合HL-FS-CT和EVLA联合HL-FS-CT干预的301例VLU患者进行回顾性比较:134例患者接受了EMA+HL-FS-CT,167例患者接受了EVLA+HL-FS-CT。两组患者溃疡愈合时间的主要结果分别为 1.45(0.75-1.5)个月和 1.86(0.5-2.5)个月(溃疡愈合的 HR 为 1.26,95% CI [0.96-1.66],p = 0.097)。次要结果包括:两组在溃疡复发、GSV再通和并发症方面无明显差异,术后两组的VCSS和AVVQ明显低于基线值(P = 0.0001):结论:EMA+HL-FS-CT和EVLA+HL-FS-CT都能有效治疗VLU。结论:EMA+HL-FS-CT 和 EVLA+HL-FS-CT 都能有效治疗 VLU,两种综合疗法都有利于溃疡的愈合,但没有证据显示哪种疗法在溃疡愈合时间上更胜一筹。
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Comparison of two ablation procedures combined with high ligation and foam sclerotherapy and compression therapy for patients with venous leg ulcers.

Aim: To compare the ablation techniques' efficacy of endovenous microwave ablation (EMA) combined with high ligation (HL), foam sclerotherapy (FS) and compression therapy (CT) and endovenous laser ablation (EVLA) combined with HL-FS-CT in the treatment of VLUs.

Method: 301 consecutive patients with VLUs from 2013 to 2022 in a 3200-bed hospital were intervened by EMA combined with HL-FS-CT and EVLA combined with HL-FS-CT were retrospectively compared.

Results: One hundred thirty-four patients underwent EMA+HL-FS-CT and 167 patients underwent EVLA+HL-FS-CT. The primary outcome of the ulcer healing time was 1.45(0.75-1.5) months and 1.86(0.5-2.5) months, respectively, in the two groups (HR for ulcer healing was 1.26, 95% CI [0.96-1.66], p = 0.097). Secondary outcomes included that no significant difference was found in ulcer recurrence and GSV recanalization and complications between the two groups, and the postoperative VCSS and AVVQ were significantly lower than the baseline values in the respective groups (p = 0.0001).

Conclusion: EMA+HL-FS-CT and EVLA+HL-FS-CT are both effective at treating VLUs. Both of the two comprehensive treatments were beneficial to the healing of ulcers, but no evidence showed which one was superior in the ulcer healing time.

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