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氰基丙烯酸酯胶联合激光治疗大隐静脉反流——一项前瞻性随机研究

Ablation therapy with cyanoacrylate glue and laser for refluxing great saphenous veins - a prospective randomised study.

作者信息

Çalık Eyüp Serhat, Arslan Ümit, Erkut Bilgehan

机构信息

Ataturk University, Faculty of Medicine, Erzurum, Turkey.

出版信息

Vasa. 2019 Aug;48(5):405-412. doi: 10.1024/0301-1526/a000792. Epub 2019 Apr 24.

Abstract

Endovenous cyanoacrylate ablation is a new technique for the treatment of clinically symptomatic venous insufficiency. The results of a prospective comparative study of cyanoacrylate glue versus endovenous laser ablation for the management of incompetent great saphenous veins are presented. Patients and methods: A total of 400 subjects were treated with cyanoacrylate ablation or endovenous laser ablation between April 2014 and April 2016. The preprocedural, procedural, postprocedural, and follow-up data were recorded and compared. There were 208 procedures in cyanoacrylate ablation group (CAA) and 204 in endovenous laser ablation group (EVLA). Operative time was 13 ± 3.4 minutes in the CAA and 31.7 ± 8.8 minutes in the EVLA (< 0.001). All procedures in both groups were successful, and the target vein segments were fully occluded at the end of the procedure. Periprocedural pain was less in the CAA (< 0.001). Enduration, ecchymosis, and paresthesia rates were significantly higher in the EVLA (< 0.001). The mean length of follow-up was 14 months (range 10-16). The 3, 6 and 12 months closure rates were 97.4%, 95.6%, and 94.1% for EVLA and 98.6%, 97.1% and 96.6% for CAA respectively. In both groups, the Venous Clinical Severity Score and Chronic Venous Insufficiency Quality of Life Questionnaire with declined significantly with no difference between groups. Management of incompetent great saphenous veins both endovenous cyanoacrylate ablation and laser ablation results in high occlusion rates. Endovenous cyanoacrylate ablation technique is fast and simple with low periprocedural pain that does not require tumescent anesthesia and compression stockings.

摘要

静脉内氰基丙烯酸酯消融术是一种治疗临床症状性静脉功能不全的新技术。本文介绍了一项关于氰基丙烯酸酯胶水与静脉内激光消融术治疗大隐静脉功能不全的前瞻性对比研究结果。患者与方法:2014年4月至2016年4月期间,共有400名受试者接受了氰基丙烯酸酯消融术或静脉内激光消融术治疗。记录并比较术前、术中、术后及随访数据。氰基丙烯酸酯消融术组(CAA)有208例手术,静脉内激光消融术组(EVLA)有204例手术。CAA组手术时间为13±3.4分钟,EVLA组为31.7±8.8分钟(<0.001)。两组所有手术均成功,手术结束时目标静脉段完全闭塞。CAA组围手术期疼痛较轻(<0.001)。EVLA组的硬结、瘀斑和感觉异常发生率显著更高(<0.001)。平均随访时间为14个月(范围10 - 16个月)。EVLA组3个月、6个月和12个月的闭合率分别为97.4%、95.6%和94.1%,CAA组分别为98.6%、97.1%和96.6%。两组的静脉临床严重程度评分和慢性静脉功能不全生活质量问卷评分均显著下降,组间无差异。静脉内氰基丙烯酸酯消融术和激光消融术治疗大隐静脉功能不全均能获得较高的闭塞率。静脉内氰基丙烯酸酯消融术技术快速简便,围手术期疼痛轻,无需肿胀麻醉和加压弹力袜。

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