Department of Surgery, University Medical Centre Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Institute of Anatomy, Christian-Albrechts-University of Kiel, Kiel, Germany.
Department of Dermatology, University Medical Centre Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
J Vasc Surg Venous Lymphat Disord. 2021 Mar;9(2):435-443. doi: 10.1016/j.jvsv.2020.05.015. Epub 2020 Jun 2.
Sclerotherapy is considered to be the method of choice for the treatment of telangiectatic varicose veins (C1 veins). Whereas the use of compression stockings after sclerotherapy is recommended, little is known about the impact of compression on the outcome of sclerotherapy. The aim of this study was to assess the influence of compression on the outcome of injection sclerotherapy of C1 varicose veins.
There were 100 legs of 50 consecutive patients with chronic venous insufficiency (C1) included. After randomization per patient, both legs were treated with sclerotherapy in a predefined area of the thigh (measuring 100 cm), followed by eccentric compression for 24 hours. Group A received no further compression, whereas group B was additionally equipped with compression stockings of 18 to 20 mm Hg above the ankle and continued wearing these for 1 week. Photodocumentation was performed before, 1 week after, and 4 weeks after sclerotherapy, and the clinical outcome was assessed at these postprocedure follow-up dates. The photographs were reviewed by an internal unblinded rater and an independent blinded external rater.
There was no discernible difference between the groups in terms of clinical outcome or side effects after 4 weeks. Whereas inter-rater reliability was high, there was no correlation between the raters and patients in terms of outcome. In 55% of the treated legs, the patients deemed the result of the treatment to be good; in 27% of the treated legs, fair; and in 18%, poor. Postprocedure hyperpigmentation occurred in 13% of patients and was comparable in both groups. Compression therapy was found to be comfortable by the majority (58%) of patients.
One week of postinterventional compression therapy had no clinical benefit compared with no compression.
硬化疗法被认为是治疗毛细血管扩张性静脉曲张（C1 静脉）的首选方法。虽然推荐在硬化疗法后使用压缩袜，但对于压缩对硬化疗法结果的影响知之甚少。本研究旨在评估压缩对 C1 静脉曲张注射硬化疗法结果的影响。
连续 50 例慢性静脉功能不全（C1）患者的 100 条腿纳入本研究。每位患者随机分组后，均在大腿的预定义区域（长 100cm）进行硬化疗法治疗，随后进行 24 小时偏心压缩。A 组未进行进一步的压缩，而 B 组则额外配备踝上 18 至 20mmHg 的压缩袜，并持续佩戴 1 周。在硬化治疗前、治疗后 1 周和 4 周进行摄影记录，并在这些术后随访日期评估临床结果。照片由内部非盲评估者和独立盲外部评估者进行评估。
4 周后，两组在临床结果或副作用方面无明显差异。尽管评估者之间的可靠性较高，但在结果方面，评估者与患者之间没有相关性。在治疗的 55%的腿中，患者认为治疗结果良好；在治疗的 27%的腿中，认为结果尚可；在 18%的腿中，认为结果较差。术后色素沉着在 13%的患者中发生，且两组间无差异。大多数（58%）患者认为压缩治疗舒适。
与无压缩相比，术后 1 周的介入后压缩治疗没有临床获益。
