Vascular Surgical Unit, Derriford Hospital, Plymouth, UK.
Eur J Vasc Endovasc Surg. 2011 Jul;42(1):115-9. doi: 10.1016/j.ejvs.2011.04.005. Epub 2011 Apr 30.
We have used ultrasound guided foam sclerotherapy (UGFS) to treat varicose veins in 2029 limbs since 2006. In 2009 we introduced physiological gas (30% O₂ and 70% CO₂) for making foam with sodium tetradecyl sulphate (Fibrovein, STD Pharmaceutical Products Ltd, Hereford UK) instead of air. The aim of this study was to compare our early experience of UFGS using CO₂/O₂ with our prior experience using air.
Data were collected in a prospectively maintained database. In this series 470 limbs were treated with UGFS and followed up at 6 weeks with clinical and duplex ultrasound assessment. The 235 consecutive limbs undergoing UGFS immediately before and the 235 after the introduction of CO₂/O₂ were selected for comparison.
The age, gender and CEAP classifications for the two groups were not significantly different. 73% were primary veins and 70% great saphenous, with no differences between the groups. Transient neurological events are rare in our experience (0.7%) with only one visual disturbance occurring in this series. There was a significant reduction in the incidence of skin staining in the CO₂/O₂ (7.2% vs 3.3%, p = 0.02, χ² test) as compared to the air treated group, but no difference in the incidence of thrombophlebitis. The total volume of foam injected was similar in both groups but use of CO₂/O₂ foam was associated with a significant improvement in the truncal occlusion rate, from 86% to 91% (p < 0.05, χ² test).
UGFS with CO₂/O₂ instead of air was associated with a slightly increased saphenous truncal occlusion rate and reduced the incidence of skin staining without increasing thrombophlebitis in this clinical series. We observed only one transient neurological event in this series so could not evaluate the effect of CO₂/O₂ foam in reducing these events.
自 2006 年以来，我们已使用超声引导下泡沫硬化疗法（UGFS）治疗了 2029 条肢体的静脉曲张。2009 年，我们使用 30%氧气和 70%二氧化碳代替空气，用十四烷基硫酸钠（Fibrovein，英国赫里福德 STD 制药产品有限公司）制作泡沫。本研究的目的是比较使用 CO₂/O₂的 UFGS 与使用空气的早期经验。
数据收集在一个前瞻性维护的数据库中。在该系列中，有 470 条肢体接受了 UGFS 治疗，并在 6 周时进行了临床和双功能超声评估。选择在引入 CO₂/O₂之前的 235 条连续肢体和之后的 235 条肢体进行比较。
两组的年龄、性别和 CEAP 分类没有显著差异。73%为原发性静脉，70%为大隐静脉，两组之间无差异。在我们的经验中，短暂性神经事件很少见（0.7%），只有 1 例在该系列中出现视力障碍。与空气处理组相比，CO₂/O₂组的皮肤染色发生率显著降低（7.2%比 3.3%，p = 0.02，卡方检验），但血栓性静脉炎的发生率无差异。两组注入的泡沫总体积相似，但使用 CO₂/O₂泡沫与隐静脉主干闭塞率显著提高相关，从 86%提高至 91%（p < 0.05，卡方检验）。
在这项临床系列研究中，使用 CO₂/O₂代替空气进行 UGFS 治疗与隐静脉主干闭塞率略有增加相关，同时减少了皮肤染色的发生率，且没有增加血栓性静脉炎的发生率。在该系列中，我们仅观察到 1 例短暂性神经事件，因此无法评估 CO₂/O₂泡沫在减少这些事件中的作用。
