Uema Rogerio Takeyoshi, Dezotti Nei Rodrigues Alves, Joviliano Edwaldo Edner, Dalio Marcelo Bellini, Moriya Takachi, Piccinato Carlos Eli
Acta Cir Bras. 2013 Nov;28(11):794-9. doi: 10.1590/s0102-86502013001100009.
To assess venous hemodynamics and quality of life at lest five years after varicose vein stripping.
We conducted a prospective study with 39 patients (63 limbs) with primary lower limbs varicose veins. Preoperatively, all patients were subjected to clinical evaluation, duplex ultrassound, air plethysmography (APG), and CIVIQ questionnaire of quality of life. By APG, venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) were determined. CIVIQ addresses four domains in course of 20 questions, including states of physical, social, and psychological well-being, and pain level. Varicose veins were treated by standard venous stripping. At least five years after surgery (77.9 ± 10.9 months), patients were reassessed and had clinical examination, duplex ultrasound, APG, and CIVIQ repeated. No late follow-up data was available for 24 patients.
Preoperative and late postoperative VFI levels were similar, whereas EF (P=0.05) and RVF (P=0.01), as hemodynamic variables, significantly improved following surgery. In the late postoperative period, overall CIVIQ scores were significantly lower (P=0.005), as were scores in all four domains: pain (P=0.001), physical (P=0.007), social (P=0.008), and psychological (P= 0.05).
In a small prospective cohort, improvements in venous hemodynamics and in quality of life of patients submitted to standard varicose veins stripping were maintained five years after the procedure.
评估大隐静脉剥脱术后至少五年的静脉血流动力学及生活质量。
我们对39例(63条肢体)原发性下肢静脉曲张患者进行了一项前瞻性研究。术前,所有患者均接受临床评估、双功超声、空气体积描记法(APG)以及生活质量CIVIQ问卷调查。通过APG测定静脉充盈指数(VFI)、射血分数(EF)和残余容积分数(RVF)。CIVIQ通过20个问题涉及四个领域,包括身体、社会和心理健康状况以及疼痛程度。采用标准静脉剥脱术治疗静脉曲张。术后至少五年(77.9±10.9个月),对患者进行重新评估,并重复进行临床检查、双功超声、APG和CIVIQ调查。24例患者无后期随访数据。
术前和术后晚期的VFI水平相似,而作为血流动力学变量的EF(P=0.05)和RVF(P=0.01)在术后显著改善。在术后晚期,CIVIQ总体评分显著降低(P=0.005),四个领域的评分均如此:疼痛(P=0.001)、身体(P=0.007)、社会(P=0.008)和心理(P=0.05)。
在一个小型前瞻性队列中,接受标准大隐静脉剥脱术的患者在术后五年保持了静脉血流动力学和生活质量的改善。