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肿胀液联合负压伤口治疗在大隐静脉传统高位结扎剥脱术中的有效性

Effectiveness of tumescent solution combined with negative pressure wound therapy in traditional high ligation and stripping of the great saphenous vein.

作者信息

Su Feng, Cheng Liu, Tong Qiao

机构信息

Department of Vascular Surgery, The Xuzhou School of Clinical Medicine of Nanjing Medical University.

Department of Vascular Surgery, Xu Zhou Central Hospital, Xuzhou.

出版信息

Medicine (Baltimore). 2020 Mar;99(11):e19040. doi: 10.1097/MD.0000000000019040.

Abstract

Traditional high ligation and stripping (THLS) is a routine operation for varicose veins. However, THLS is accompanied with postoperative subcutaneous ecchymosis and pain. In this current study, we aimed to explore the effect of tumescence solution (TS) combined with negative pressure wound therapy (NPWT) on the relief of subcutaneous ecchymosis and pain after THLS of great saphenous vein.A total of 180 patients receiving THLS were enrolled in group A, and 120 patients undergoing THLS and TS combined with NPWT were assigned into group B. The occurrences of subcutaneous ecchymosis and pain were recorded. Moreover, the total area of subcutaneous ecchymosis was estimated by the grid method. Visual analogue scale (VAS) score was used to assess the pain level of both groups.Preoperative characteristics were not significantly different between 2 groups. Postoperative ecchymosis occurred in 112 cases (62.2%) of group A and 41 cases (34.2%) of group B. The area of ecchymosis in group A (66.6 ± 44.5) cm was larger than that in group B (25.2 ± 19.9) cm. The number of patients without obvious pain in group A (57, 31.7%) was significantly less than that in group B (77, 64.2%) after operation. In addition, VAS score in group A (3.1 ± 2.6) was higher than that in group B (2.2 ± 1.9).In conclusion, the application of TS combined with NPWT in THLS can not only alleviate subcutaneous ecchymosis and pain, but also prevent the occurrence of subcutaneous ecchymosis and pain after operation. Therefore, it is conducive to postoperative recovery and is suitable for clinical application.

摘要

传统高位结扎剥脱术(THLS)是治疗静脉曲张的常规手术。然而,THLS术后会出现皮下瘀斑和疼痛。在本研究中,我们旨在探讨肿胀液(TS)联合负压伤口治疗(NPWT)对大隐静脉THLS术后皮下瘀斑和疼痛缓解的影响。

共有180例行THLS的患者纳入A组,120例行THLS且TS联合NPWT的患者被分配到B组。记录皮下瘀斑和疼痛的发生情况。此外,采用网格法估计皮下瘀斑的总面积。采用视觉模拟评分法(VAS)评估两组的疼痛程度。

两组术前特征无显著差异。A组术后发生瘀斑112例(62.2%),B组41例(34.2%)。A组瘀斑面积(66.6±44.5)cm大于B组(25.2±19.9)cm。术后A组无明显疼痛的患者数量(57例,31.7%)显著少于B组(77例,64.2%)。此外,A组VAS评分(3.1±2.6)高于B组(2.2±1.9)。

综上所述,TS联合NPWT应用于THLS不仅能减轻皮下瘀斑和疼痛,还能预防术后皮下瘀斑和疼痛的发生。因此,有利于术后恢复,适合临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a251/7440248/dcea765e0116/medi-99-e19040-g001.jpg

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