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[静脉曲张手术的经济方面。对门诊治疗的呼吁]

[Economic aspects of varices surgery. A plea for ambulatory treatment].

作者信息

Gorin J P, Nossin F, Radier P

出版信息

Phlebologie. 1979 Oct-Dec;32(4):325-32.

PMID:120944
Abstract

Health expenses have increased in recent years in the majority of western countries. The treatment of varicose veins of the lower limbs occupies an important position from the budgetary point of view, and the duration of hospitalisation is clearly a determining factor. Apart from other methods currently being investigated--Dextran, intermittent pneumatic compression, anti-aggregants--low dose heparin therapy appears to be 80% effective in the prevention of post-operative thromboembolic complications. In the same way local complications after varicose surgery--haematomas, lymphoedema--have disappeared, as a result of progress in surgical technique (fine, atraumatic dissection, rigorous haemostasis) and improvement in methods of bandaging. In the light of our last fifty ligations and stripping of the internal saphenous vein, notably without thromboembolic complications, it seems reasonable to consider short hospital stays, of three days, with the exception of "high risk" patients. "Out-patient" treatment (24 hours) can be considered for patients who are "active and motivated".

摘要

近年来,大多数西方国家的医疗费用都有所增加。从预算角度来看,下肢静脉曲张的治疗占据重要地位,而住院时间显然是一个决定性因素。除了目前正在研究的其他方法——右旋糖酐、间歇性气动压迫、抗聚集剂——低剂量肝素疗法在预防术后血栓栓塞并发症方面似乎有80%的疗效。同样,由于手术技术的进步(精细、无创解剖、严格止血)和包扎方法的改进,静脉曲张手术后的局部并发症——血肿、淋巴水肿——已经消失。根据我们最近对50例大隐静脉结扎和剥脱术的观察,特别是没有血栓栓塞并发症,除“高危”患者外,考虑三天的短期住院似乎是合理的。对于“活跃且有积极性”的患者,可以考虑“门诊”治疗(24小时)。

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