射频消融与传统高位结扎剥脱术治疗大隐静脉曲张的随机临床试验。

Randomized clinical trial of radiofrequency ablation or conventional high ligation and stripping for great saphenous varicose veins.

机构信息

Department of General Surgery, King's Mill Hospital, Mansfield, UK.

出版信息

Br J Surg. 2010 Mar;97(3):328-36. doi: 10.1002/bjs.6867.

DOI:10.1002/bjs.6867

PMID:20035541

Abstract

BACKGROUND

This randomized clinical trial compared early outcomes after radiofrequency ablation (RFA) and conventional surgery for varicose veins.

METHODS

Consecutive patients with symptomatic varicose veins due to isolated great saphenous vein (GSV) incompetence and suitable for RFA were randomized to either RFA or conventional surgery (saphenofemoral disconnection and stripping). Clinical, radiological and patient-based outcomes were recorded at 1 and 5 weeks after intervention.

RESULTS

RFA resulted in successful obliteration of the GSV in all 47 patients. Complete above-knee stripping was unsuccessful in seven of 41 patients. RFA took longer than conventional surgery: median interquartile range 76 (67-84) versus 48 (39-54) min; P < 0.001. Patients returned to their normal activities significantly earlier after RFA (median 3 (2-5) versus 12.5 (4-21) days; P < 0.001). Postoperative pain was significantly less after RFA (median score on visual analogue scale 1.70 (0.50-4.30) versus 4.0 (2.35-6.05); P = 0.001). Patient satisfaction, quality of life improvement and analgesic requirements significantly favoured RFA.

CONCLUSION

RFA took longer to perform but resulted in a significantly better early outcome than conventional surgery in suitable patients with great saphenous varicose veins.

摘要

背景

本随机临床试验比较了射频消融（RFA）和传统手术治疗静脉曲张的早期结果。

方法

连续入选因孤立性大隐静脉（GSV）功能不全且适合 RFA 的症状性静脉曲张患者，随机分为 RFA 组或传统手术组（股隐静脉离断和剥脱）。干预后 1 周和 5 周记录临床、影像学和患者为基础的结局。

结果

47 例患者的 GSV 均成功闭塞。41 例患者中，7 例完全膝关节以上剥脱失败。RFA 耗时明显长于传统手术：中位数[四分位数间距]76（67-84）比 48（39-54）min；P<0.001。RFA 后患者更早恢复正常活动（中位数 3[2-5]比 12.5[4-21]天；P<0.001）。RFA 后术后疼痛明显较轻（中位数视觉模拟评分 1.70[0.50-4.30]比 4.0[2.35-6.05]；P=0.001）。RFA 组患者满意度、生活质量改善和镇痛需求明显更好。