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超声引导下泡沫硬化疗法对慢性静脉疾病和大隐静脉反流患者疼痛控制的影响

Impact of Ultrasound-Guided Foam Sclerotherapy for Pain Control in Patients with Chronic Venous Disease and Great Saphenous Vein Reflux.

作者信息

Poschinger-Figueiredo Douglas, Virgini-Magalhães Carlos Eduardo, Amorim Claudia Salvador, Poschinger Alessandra Krykhtine Peres, Chequer Fernanda Pires

机构信息

Teaching and Health Care Unit of Vascular and Endovascular Surgery (CT Vascular), Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.

出版信息

Int J Angiol. 2022 Nov 11;32(3):172-178. doi: 10.1055/s-0042-1758384. eCollection 2023 Sep.

Abstract

Chronic venous disease (CVD) associated with great saphenous vein (GSV) reflux has a higher prevalence of pain in the lower limbs. This study evaluates the impact of ultrasound-guided foam sclerotherapy (UGFS) for GSV and symptom control, accessed by the visual analogue scale (VAS). Patients with CVD who underwent GSV-UGFS were included in this retrospective cohort (417 limbs). The pain was measured before and after the treatment. The scale alteration was assessed as a function of age, sex, Clinical Etiologic Anatomic Pathophysiologic (CEAP) classes, total of sclerotherapy sessions, GSV occlusion patterns, and ulcer healing. Majority of patients were female (59.2%), and the mean age was 56 ± 11.5 years. In the total sample, 78.2% of the GSVs were fully occluded, 19.7% had partial occlusion, 2.2% remained open, and 3.2 ± 1.9 (median = 3.0) sessions were performed. The reduction of symptoms occurred in 88.3% of participants (VAS drop median = 4.8). Patients younger than 50 years and females had the greatest VAS decreases. When comparing the outcomes of complete occlusion versus partial occlusion, there was no significant difference in VAS pain reduction (  = 0.14). The comparison between CEAP clinical classes also did not show statistically significant differences in delta VAS (  = 0.71). GSV-UGFS was effective for pain control. However, this improvement does not appear to be related to the pattern of occlusion, indicating that in the short term, the outcomes of total and partial occlusion suggest successful management of symptoms. Other aspects such as gender, age, pretreatment pain intensity, and CEAP classes seem to play a role in the clinical outcome.

摘要

与大隐静脉(GSV)反流相关的慢性静脉疾病(CVD)在下肢疼痛方面具有更高的患病率。本研究通过视觉模拟量表(VAS)评估超声引导下泡沫硬化疗法(UGFS)对GSV及症状控制的影响。接受GSV-UGFS治疗的CVD患者被纳入该回顾性队列研究(共417条肢体)。在治疗前后测量疼痛程度。根据年龄、性别、临床病因解剖病理生理(CEAP)分级、硬化疗法总疗程数、GSV闭塞模式以及溃疡愈合情况评估量表变化。大多数患者为女性(59.2%),平均年龄为56±11.5岁。在整个样本中,78.2%的GSV完全闭塞,19.7%部分闭塞,2.2%保持开放状态,且进行了3.2±1.9(中位数 = 3.0)次疗程。88.3%的参与者症状减轻(VAS降幅中位数 = 4.8)。年龄小于50岁的患者和女性的VAS降幅最大。比较完全闭塞与部分闭塞的结果时,VAS疼痛减轻方面无显著差异(P = 0.14)。CEAP临床分级之间的比较在VAS差值方面也未显示出统计学上的显著差异(P = 0.71)。GSV-UGFS对疼痛控制有效。然而,这种改善似乎与闭塞模式无关,表明短期内,完全闭塞和部分闭塞的结果均提示症状得到成功控制。其他方面,如性别、年龄、治疗前疼痛强度和CEAP分级似乎在临床结果中发挥作用。

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