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[标准及血管内静脉曲张手术的现状]

[Current status of standard and endovascular varicosity surgery].

作者信息

Noppeney T, Nüllen H

出版信息

Hautarzt. 2006 Jan;57(1):33-9. doi: 10.1007/s00105-005-1083-6.

Abstract

The classical varicose vein operation represents the "gold standard" in the operative approach to this condition. The results of the standard procedure are very good especially with regard to complications. The recurrence rate is estimated between 6% and 60%, but the true rate is unknown, since there is no generally accepted definition of recurrent varicosities. Endovascular procedures for the elimination of the superficial venous system - radiofrequency obliteration and laser therapy - have established themselves as alternative, minimal invasive procedures. Good results up to 2 years post operatively have been documented; for radiofrequency obliteration, very good results 5 years after surgery are available. Less well-known procedures are available, such as the CHIVA method, which represents a totally different pathophysiological concept. Data on the efficacy of this method are limited, making an evaluation difficult. The spectrum of operative treatment methods of the superficial venous system and its side branches has increased tremendously because of new technical developments. The surgeon must inform the patient about the pros and cons of each procedure and the anticipated results, as well as making an accurate decision as to which methods are best suited for the patient.

摘要

经典的静脉曲张手术是治疗这种疾病的手术方法中的“金标准”。标准手术的效果非常好,尤其是在并发症方面。复发率估计在6%至60%之间,但由于对复发性静脉曲张没有普遍接受的定义,所以真实的复发率尚不清楚。用于消除浅静脉系统的血管内手术——射频消融和激光治疗——已成为替代的微创方法。术后长达2年的良好效果已有记录;对于射频消融,术后5年有非常好的效果。还有一些不太知名的手术方法,如CHIVA方法,它代表了一种完全不同的病理生理概念。关于这种方法疗效的数据有限,难以进行评估。由于新技术的发展,浅静脉系统及其侧支的手术治疗方法范围大幅增加。外科医生必须告知患者每种手术的利弊、预期结果,并准确决定哪种方法最适合该患者。

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