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[静脉内激光治疗:一种治疗静脉曲张的新方法]

[Endovenous laser therapy: a new treatment for varicose veins].

作者信息

van den Bremer J, Hedeman Joosten P P A, Moll F L

机构信息

Leids Universitair Medisch Centrum, afd. Heelkunde, Postbus 9600, 2300 RC Leiden.

出版信息

Ned Tijdschr Geneeskd. 2007 Apr 28;151(17):960-5.

Abstract

Varicose veins are very common. For years the most commonly applied treatment for great saphenous vein (GSV) insufficiency was saphenofemoral junction ligation with saphenous vein stripping. Minimally invasive methods, such as the endovenous laser therapy, are increasingly used during the last few years. In endovenous laser therapy, a diode laser fibre is inserted percutaneously into the GSV using ultrasonography to confirm the position. Thermal laser energy is applied to the endothelium ofthe GSV, resulting in local venous occlusion. The procedure has rapidly become popular with clinicians who treat varicose veins due to its relative simplicity and high rate of patient satisfaction. Efficacy outcomes are good with an occlusion rate of up to 100%. Recanalisation is rarely occurring even after several years. Pain, haematoma and phlebitis are common adverse events associated with endovenous laser therapy but in most cases are self-limiting. Serious adverse events, such as deep vein thrombosis, are uncommon. The advantages ofendovenous laser therapy are the lack of surgical wounds, so infection and scarring are avoided, and that the procedure can be performed in an outpatient setting using local anaesthesia. Endovenous laser therapy appears to be a safe and effective treatment option for refluxing varicose veins.

摘要

静脉曲张非常常见。多年来,治疗大隐静脉(GSV)功能不全最常用的方法是大隐静脉股静脉交界处结扎术并剥脱大隐静脉。近年来,诸如静脉内激光治疗等微创方法的使用越来越多。在静脉内激光治疗中,使用超声检查确认位置后,将二极管激光光纤经皮插入大隐静脉。向大隐静脉的内皮施加激光热能,导致局部静脉闭塞。由于其相对简单且患者满意度高,该手术已迅速受到治疗静脉曲张的临床医生的欢迎。疗效良好,闭塞率高达100%。即使几年后也很少发生再通。疼痛、血肿和静脉炎是与静脉内激光治疗相关的常见不良事件,但在大多数情况下是自限性的。严重不良事件,如深静脉血栓形成,并不常见。静脉内激光治疗的优点是没有手术伤口,因此避免了感染和瘢痕形成,并且该手术可以在门诊使用局部麻醉进行。静脉内激光治疗似乎是治疗反流性静脉曲张的一种安全有效的选择。

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