Bihari Imre
Semmelweis Egyetem, Egészségügyi Fôiskolai Kar, Klinikai Tanszék, Budapest, Népszínház u. 42-44, 1081.
Orv Hetil. 2007 Jan 14;148(2):51-8. doi: 10.1556/OH.2007.27846.
The author began to deal with injection sclerotherapy 25 years ago, which is still being practised by him to this day.
Experience is drawn from 115 000 injections given to 4025 limbs of 3107 patients. The mean age is 41.7 years, 80.3% of patients were women.
For decades, medicines necessary for sclerotherapy (polidocanol, tetradecylsulphate) have been available in Hungary. At the same time diagnosis and method have developed both abroad and in Hungary. Instead of the previously used standard standing position, the patient is either sitting or lying during the puncture. The diameter of the needle used is smaller than earlier. Previously at the injection the patient was lying and her leg was raised, but now usually she is in the same position as during the puncture. The amount of given medicine at one session was 1 x 0.2 ml, later 4 and 6 x 0.5 ml, but now the allowed maximal dosage is 28 ml 0.5%.
Treatments were successful in every case and there were not any serious complications. This method has an outstanding importance in the treatment of intracutaneous venectases and reticular varicosis but side branches and perforators can be cured as well. As is well known, varicosity is a progressive disease and the sclerotherapy can be repeated unrestricted. It is therefore suitable for its treatment in the long run. Strong reactions and complications: The most common strong reactions are fainting, suffusion, phlebitis and pigmentation at the site of the injection.
Very rarely blistering, allergic reaction and deep venous thrombosis. The latter is highly focused, therefore the patient's thrombophilic history is revealed. The authors' results and the survey in Hungary showed 1.5% complication in treated patients including one non serious deep venous thrombosis. The recently introduced ultrasound-guided foam sclerotherapy of the leg is suitable for the injection of stem varicosities. Successful treatments were carried out not only in the lower leg but also in upper limb varicosities, vascular malformations, venous lake of the lip and hemorrhoidal nodes. The sclerotherapy and operation rather supplement each other than compete.
Sclerotherapy has proved to be suitable for the therapy of lower limb varicosity and some other venous dilatations.
作者25年前开始从事注射硬化疗法，至今仍在应用。
经验来自于对3107例患者的4025条肢体进行的115000次注射。平均年龄为41.7岁，80.3%的患者为女性。
几十年来，匈牙利一直有硬化疗法所需的药物（聚多卡醇、十四烷基硫酸盐）。与此同时，国外和匈牙利的诊断方法及技术都有所发展。穿刺时患者不再采用先前的标准站立姿势，而是坐着或躺着。所用针头的直径比以前更小。以前注射时患者躺着且腿部抬起，但现在通常与穿刺时姿势相同。一次注射的药量以前是1×0.2毫升，后来是4至6×0.5毫升，但现在允许的最大剂量是28毫升0.5%。
每次治疗均成功，未出现任何严重并发症。该方法在治疗皮内静脉扩张和网状静脉曲张方面具有突出重要性，但侧支血管和穿通支也可治愈。众所周知，静脉曲张是一种进行性疾病，硬化疗法可不受限制地重复进行。因此，从长远来看，它适用于静脉曲张的治疗。强烈反应和并发症：最常见的强烈反应是昏厥、充血、静脉炎和注射部位色素沉着。
非常罕见的有起泡、过敏反应和深静脉血栓形成。后者高度集中，因此要了解患者的血栓形成倾向病史。作者的结果以及匈牙利的调查显示，接受治疗的患者中有1.5%出现并发症，其中包括一例不严重的深静脉血栓形成。最近引入的腿部超声引导下泡沫硬化疗法适用于主干静脉曲张的注射。不仅小腿静脉曲张，上肢静脉曲张、血管畸形、唇部静脉湖和痔核的治疗也取得了成功。硬化疗法和手术更多的是相互补充而非相互竞争。
硬化疗法已被证明适用于下肢静脉曲张及其他一些静脉扩张的治疗。
