大隐静脉曲张的微创手术方法—激光治疗

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1、大隐静脉曲张的微创手术方法—激光治疗作者:黄曙光，张英男，刘立新，马军【摘要】目的通过与传统的大隐静脉高位结扎、浅静脉剥脱术相比，考察大隐静脉曲张激光治疗的可行性及其疗效。方法选择进口激光治疗仪对我科2003年初至今的43例患者施行激光治疗，选择病例均为大隐静脉主干曲张型且病情较轻者；常规硬膜外麻醉或腰麻，穿刺内踝上方大隐静脉主干，向上插入泥鳅导丝，顺导丝导入导管，撤出导丝交换激光光纤，确认在大隐静脉主干，开启激光，设定好功率，边烧边退，同时助手沿大隐静脉沿途压迫，使静脉腔闭合，全程大约50～80s。烧灼完毕后，弹力绷带加压包扎。术后两天出院，2周后解除弹力绷带，配弹力袜3～6个月。结

2、果43例患者无短期术后并发症发生，单侧肢体平均手术时间27min，最短仅为12min；术后随访3～6个月，多数效果良好，1例复发，再行大隐静脉高位结扎浅静脉剥脱术而痊愈。结论大隐静脉的激光治疗对大隐静脉曲张主干型且分支曲张病情较轻者，效果良好，但其远期疗效尚待有进一步观察。【关键词】大隐静脉曲张;激光治疗Miniinvasiveoperation-lasertreatmentforgreatsaphenosveinvaricosis6【Abstract】ObjectiveDiscussthefeasibilityandtherapeuticeffectofendovenouslaser

3、treatment(EVLT)forvaricoseveinoflowerextremitybycontrastingwithtraditionalhighligationandstrippingofthegreatsaphenousvein.MethodsWeselectedtheEVLTtotreat43patientsinourdepartmentbyusinglasertreatmentinstrument.Wechosethepatientswithvenoustrunktypewhicharenotserious.Afterepiduralanesthesiaorlumba

4、ranesthesiawestickthroughthetrunkofgreatsaphenousveinsuperiorthemedialmalleolus.Inserttheguidewireupward，theninsertthevesselalongtheguidewire，thenwithdrawtheguidewireandinsertfiberthroughvessel.Firstyoumustonfirmthatthelaserfiberisinthevenoustrunk，thenturnonthelaser，enactmentpower，pullthefiberan

5、dcauterizeatthesametimewhiletheassistantpressthelegalongthegreatsaphenousvientomakethelumenofveinocclusion.Itmaybelast50～80s.Aftertheoperationweusepressurebandagestomakeapressuredressing.Atthethirddayaftertheoperationpatientcanleavethehospital.Pressurebandagescanbetakenoffaftertwoweeks，thendress

6、ingcompressionsocksfor3～6months.ResultsThe43patientsdidnothaveshort-termcomplicationaftertheoperation.Averagesurgerytimeis27minutesinsingleleg.Theshortestisonly612minutes；Afteroperationwemadeafollow-upfor3～6months，Themosteffectsaregood，only1patientretured，thenherecoveredafterhighligationandstrip

7、ping.ConclusionEVLTeffertivetreatmenttopatientswithvenoustrunktypeandramusvaricoseveinisnotserious，butitsprospecdtiveefficacyneedfurtherobservation.【Keywords】varicosisofgreatsaphenousvein;lasertreatment下肢静脉曲张是一种常见且多发的疾病，早在公元