Reich-Schupke S, Weyer K, Altmeyer P, Stücker M
Ruhr-University Bochum, Bochum, Germany.
Vasa. 2010 May;39(2):169-74. doi: 10.1024/0301-1526/a000023.
Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter.
Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2 ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy.
110 legs (CEAP C2-C4) were followed up for a period of 14.2 +/- 4.2 months. Reflux was eliminated after 3.4 +/- 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 +/- 0.9 months and in 48.2 % after 14.2 +/- 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 +/- 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred.
Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.
尽管在日常实践中，泡沫硬化疗法治疗曲张属支很常见，但关于最佳硬化剂浓度和治疗频率的科学证据仍然不足。本研究旨在增加对曲张属支泡沫硬化疗法的认识，并评估0.5%聚多卡醇泡沫硬化疗法治疗直径3 - 6毫米属支的疗效和安全性。
对76例患者的110条腿进行分析。每隔一天或第三天进行一次注射。每次注射每腿最多1次，每次注射量为2毫升。在治疗开始后约6个月和12个月进行对照检查。
110条腿（CEAP C2 - C4）随访了14.2±4.2个月。每腿平均经过3.4±2.7次注射后反流消失。分别在6.2±0.9个月和14.2±4.2个月时，发现23.2%和48.2%的属支不足。只有30.9%（34/110）的腿需要额外治疗。6.4%的患者接受了静脉手术，24.5%的患者重复了类似的硬化疗法。与初始治疗相比，所需的硬化疗法疗程显著减少（平均：2.3±1.4，p = 0.0054）。在整个研究期间，发生了血栓性静脉炎（8.2%）、色素沉着（14.5%）、治疗区域硬结（9.1%）、治疗腿疼痛（7.3%）和偏头痛（0.9%）。1例有血栓形成病史的患者发生了肌静脉血栓形成（0.9%）。一年后仅遗留色素沉着（8.2%）和硬结（1.8%）。未发生严重不良反应。
每2天或3天注射0.5%聚多卡醇的泡沫硬化疗法是治疗曲张属支的安全方法。疗效评估困难，因为很难判断对照检查中发现的属支是复发静脉还是在随访期间新出现的。再次治疗的腿数较少表明疗效高且患者满意度高。
