钬激光下肢静脉曲张腔内治疗临床研究

《钬激光下肢静脉曲张腔内治疗临床研究》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、钬激光下肢静脉曲张腔内治疗临床研究作者：褚雪峰，缪秀华，圣小平，张松贵，许晓萍，陈正言【摘要】目的：探讨钬激光治疗下肢静脉曲张的机理。方法：（1）对经钬激光治疗术后的下肢静脉曲张患者进行彩色多谱勒超声监测；（2）对离体大隐静脉进行实验，比较大隐静脉内不同介质在钬激光作用于血管壁过程中的影响；（3）活体治疗后的大隐静脉段病理检查；（4）术前术后血D-二聚体、纤维蛋白原值比较分析。结果：（1）治疗后大隐静脉腔内即见实性回声，随诊发现回声逐渐增强，大隐静脉内径均比术前有不同程度缩小，腔内无血流信号；（2）、病理显示，钬

2、激光治疗后大隐静脉内皮消失，内、中、外膜均不同程度的变性、坏死；（3）血管内不同介质直接影响钬激光对血管壁的作用结果；（4）手术前、后血D-二聚体值比较差异有统计学意义（P﹤0.01），纤维蛋白原值比较差异有统计学意义（P﹤0.05）。结论：钬激光可诱导静脉壁增厚、挛缩、内径缩小，最终静脉闭锁。血液是钬激光作用于血管壁过程中的必需介质，术后存在有高凝状态。【关键词】下肢静脉曲张；钬激光；彩色多普勒超声检查；酶联免疫吸附试验[Abstract]Objective:Toresearchthemechanismof8t

3、reatmentforthephlebeurysmalowerlimbswithholmiumlaser.Methods:（1）ColourDopplersupersonicmonitoringwascarriedoutonthepatientstreatedforphlebeurysmalowerlimbswithholmiumlaser.（2）Experimentswereconductedongreatersaphenousveininvitro;Theeffectsofdifferentmediaingr

4、eatersaphenousveinwerecomparedwhenholmiumlaserwasaffectingthebloodvesselwall.（3）Pathologicalexaminationswereconductedonthegreatersaphenousveinsectionaftertreatingthelivingbody.（4）ContrastandanalysisofD-dimerandhemaleucinoriginalvalueinbloodweremadebeforeandaf

5、teroperation.Results:（1）Therewassubstantiveechoingreatersaphenousveinsoonafterthetreatment.Thesubstantiveechobecamestrongwhenreexamined.Theboresizebecamesmallerinsomeways.Andtherewasnosignofbloodflowinthecavity.（2）Pathologicalmechanismshowedthatthebastingreat

6、ersaphenousveindisappearedafterbeingtreatedbyholmiumlaser.Theinner,middleandoutermembranesalldenaturatedornecrosedinsomeways.（3）Differentmediainbloodvesselaffectedtheeffectofholmiumlaseronbloodvesselwalldirectly.（4）TherewasaremarkabledifferenceinD-dimer(P<

7、0.01)andhemaleucinoriginalvalue(P<0.05)inbloodbeforeandaftertheoperation.Conclusion:Holmiumlasercan8leadtothrombosisingreatersaphenousvein.Withdestroyingthenormalstructureofbloodvesselwall,itcausesthedamagedveinwalltobecomethickerandcontract.Thustheboresiz

8、ebecomesnarrower.Atlasttheveinisshutting.Bloodisthenecessarymediumwhenholmiumlaserisaffectingthebloodvesselwall.Bloodcongealsquickerafteroperation.[Keywords]Phlebeurysmalowerlimbs；Holmium