目的：探讨DSA引导下聚桂醇泡沫硬化剂治疗下肢静脉曲张性溃疡的临床疗效。方法：回顾性分析2013年1月—2015年12月15例（17条患肢）下肢静脉曲张合并溃疡的患者。术前行下肢顺行静脉造影，明确溃疡下浅静脉位置及走行，术中穿刺溃疡周围浅静脉，注入聚桂醇泡沫硬化剂，术后患肢加压，并及时更换弹力袜，随访6月。结果：15例患者17条患肢均成功注入泡沫硬化剂，技术成功率100%，每条患肢平均注入泡沫硬化剂5.5 mL，无下肢深静脉血栓、肺栓塞等严重并发症发生，术后当天患者能下床活动，17例患肢分别于术后7 d~3月愈合，1例内踝患肢术后5月复发。结论：DSA引导下泡沫硬化剂治疗下肢静脉曲张性溃疡是一项成功率高，住院时间短，疗效显著的微创方法。
Abstract
Objective: To explore the clinical effects of DSA-guided foam sclerosing lauromacrogol in the treatment for varicose vein and ulcer of lower extremity. Methods: A retrospective analysis was carried out on 15 patients with varicose vein and ulcer of lower extremity from January 2013 to December 2015, and preoperative anterograde venography was given, to confirm the location and direction of superficial vein below ulcer. Superficial veins around the ulcer were punctured during the operation and foam sclerosing lauromacrogol was injected. Postoperative diseased limb was compressed and stretch socks were changed timely. The patients were followed up for 6 months. Results: All 17 diseased limbs of 15 patients were successfully injected with foam sclerosing agent, and the successful rate of technology was 100%. Each diseased limb was injected with 5.5 mL foam sclerosing agent on average. There were no server complications such as deep vein thrombosis of lower extremity and pulmonary embolism, etc. Patients could do off-bed activities after operation. Seventeen diseased limbs healed in 7 days to 3 months after operation, and 1 case recurred in postoperative 5 months for diseased medial malleolus. Conclusions: DSA guided foam sclerosing lauromacrogol is a minimally-invasive method with high success rate, shorter hospitalization stays and distinct curative effects in the treatment for varicose vein and ulcer of lower extremity.
关键词
静脉曲张溃疡 /
下肢 /
血管造影术 /
数字减影
Key words
Varicose ulcer /
Lower extremity /
Angiography, digital subtraction
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基金
常熟市卫生局资助性重点项目（csws201412）。
