Campbell W B, Decaluwe H, Boecxstaens V, MacIntyre J A, Walker N, Thompson J F, Cowan A R
Department of Surgery, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
Eur J Vasc Endovasc Surg. 2007 Dec;34(6):741-4. doi: 10.1016/j.ejvs.2007.07.012. Epub 2007 Sep 17.
To investigate the activities which may exacerbate symptoms in patients with varicose veins.
Questionnaires sent to patients before clinics and at least six months later.
Both questionnaires were returned by 149 of 203 patients (74%) but only 124 contained adequate data for comparison--55 from patients who had surgical treatment and 69 who had no surgery. At initial presentation, worsening of discomfort attributed to varicose veins was common during (58%) or after (48%) standing and in hot weather (44%), but less when sitting with the feet down (31%), and after (31%) or when walking (19%). Surgery significantly reduced the total number of symptoms reported by patients at follow-up (p<0.02). However, none of the symptoms reported during specific activities was significantly lessened by surgery compared with no treatment--possibly because the attrition of patients during the study resulted in small numbers for analysis.
Symptoms are a common indication for treating varicose veins and it is therefore important to be sure that they are due to the veins, rather than other causes. This report highlights traditional and logical questions which may help to identify symptoms caused by varicose veins but illustrates the difficulty of validating them.
调查可能加重静脉曲张患者症状的活动。
在门诊前及至少六个月后向患者发放问卷。
203名患者中有149名（74%）返回了两份问卷，但只有124份包含足够的数据用于比较——55份来自接受手术治疗的患者，69份来自未接受手术的患者。在初次就诊时，因静脉曲张导致的不适在站立期间（58%）或之后（48%）以及炎热天气（44%）时加重较为常见，但在脚下垂坐着时（31%）以及之后（31%）或行走时（19%）加重较少。手术显著减少了随访时患者报告的症状总数（p<0.02）。然而，与未治疗相比，手术并未使特定活动期间报告的任何症状显著减轻——可能是因为研究期间患者流失导致用于分析的数量较少。
症状是治疗静脉曲张的常见指征，因此重要的是要确定症状是由静脉引起的，而非其他原因。本报告强调了一些传统且合理的问题，这些问题可能有助于识别由静脉曲张引起的症状，但也说明了验证这些问题的难度。
