Uncu H
Ankara Universitesi Tip Fakültesi, Genel Cerrahi Anabilim Dali, Ibni Sina Hastanesi, K-4 Blok, 06100 Ankara, Turkey.
Phlebology. 2010 Feb;25(1):44-9. doi: 10.1258/phleb.2009.008064.
Compression sclerotherapy has been satisfactorily used for half a century for the treatment of varicose veins of the lower extremities. The effect of sclerosing solutions is that of making endofibrosis and vascular damage via producing endothelial injury. Different sclerosing agents were used by applying many different sclerotherapy methods. In recent years, sclerosing foam has been introduced in sclerotherapy with the goal of increasing the efficacy in the treatment of varicose veins. It is still uncertain whether foam or liquid form is superior. The aim of this study is to determine the efficacy and safety of the sclerosant polidocanol - which is a well-known detergent-type sclerosing agent - in foam form compared with liquid form.
A total of 100 women patients with telengiectases and small varicose veins of less than 4 mm were included in this study. The patients were divided into two groups according to presenting dates. Fifty patients who presented first were classified as the first group. They were treated with Tessari's foam sclerotherapy method. The second fifty patients who presented later were placed in the second group. They were treated with the liquid form of polidocanol. Extremity veins that did not have insufficiency at the saphenofemoral junction were divided into three groups as <1 mm, 1-2 mm and >2 but <4 mm, and the veins were treated with 0.25%, 0.5% or 1% of polidocanol, respectively. Clinical improvement, patients' complaints and side-effects were determined after treatment.
Complete disappearance was determined in 84% of patients in the foam form group and in 72% in the liquid form group. Although polidocanol in foam form's success rate was higher than the liquid form of polidocanol to clear the vessels, this result did not reach statistical significance (P = 0.148). There was no significant difference also in the side effects between each group.
Compression sclerotherapy is an effective and useful method for treating small varicose veins and telengiectases. Both polidocanol foam and polidocanol liquid forms are effective and safe sclerosing agents. The rates of side-effects were similar for both sclerotherapy methods. Although efficacy to clear the small varicose veins and telengiectases with foam polidocanol seems to be more successful than with liquid polidocanol, it is early to declare the superiority of the foam sclerotherapy method.
压迫硬化疗法已成功用于治疗下肢静脉曲张达半个世纪之久。硬化剂的作用是通过造成内皮损伤来引发内膜纤维化和血管损伤。人们应用多种不同的硬化疗法使用不同的硬化剂。近年来，硬化泡沫已被引入硬化疗法，目的是提高治疗静脉曲张的疗效。泡沫剂型还是液体剂型更具优势仍不明确。本研究的目的是确定泡沫剂型的硬化剂聚多卡醇（一种著名的去污剂型硬化剂）与液体剂型相比的疗效和安全性。
本研究共纳入100例患有毛细血管扩张和直径小于4mm的小静脉曲张的女性患者。根据就诊日期将患者分为两组。首先就诊的50例患者被归为第一组。她们接受泰萨里泡沫硬化疗法。后就诊的50例患者被归为第二组。她们接受聚多卡醇液体剂型治疗。大隐静脉股静脉交界处无功能不全的肢体静脉按直径分为三组，即<1mm、1 - 2mm和>2但<4mm，分别用0.25%、0.5%或1%的聚多卡醇治疗。治疗后确定临床改善情况、患者主诉及副作用。
泡沫剂型组84%的患者血管完全消失，液体剂型组为72%。虽然泡沫剂型的聚多卡醇清除血管的成功率高于液体剂型的聚多卡醇，但该结果未达到统计学显著性（P = 0.148）。两组之间的副作用也无显著差异。
压迫硬化疗法是治疗小静脉曲张和毛细血管扩张的有效且实用的方法。聚多卡醇泡沫和聚多卡醇液体剂型都是有效且安全的硬化剂。两种硬化疗法的副作用发生率相似。虽然泡沫聚多卡醇清除小静脉曲张和毛细血管扩张的疗效似乎比液体聚多卡醇更成功，但现在宣称泡沫硬化疗法具有优越性还为时过早。
