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冷冻激光冷冻硬化疗法与硬化疗法治疗毛细血管扩张和网状静脉的对比研究:一项随机对照试验。

A comparative study between cryo-laser cryo-sclerotherapy and sclerotherapy in the treatment of telangiectasia and reticular veins: A randomized controlled trial.

机构信息

Department of Vascular and Endovascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

Department of Vascular and Endovascular Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt; Vascular and Endovascular Surgery Department, Sheffield Teaching Hospitals NHS, Sheffield, UK.

出版信息

J Vasc Surg Venous Lymphat Disord. 2024 Jul;12(4):101874. doi: 10.1016/j.jvsv.2024.101874. Epub 2024 Mar 24.

Abstract

OBJECTIVE

Telangiectasias, characterized by dilated venules, are frequently observed in the lower extremities. Sclerotherapy stands out as the predominant treatment of these vascular lesions. The integration of laser therapy with a mild sclerosing agent, serving as an osmotic sclerosant, presents an enhanced cosmetic treatment approach, aiming to optimize outcomes and minimize potential adverse effects. This study sought to evaluate the feasibility, efficacy, and safety of cryo-laser and cryo-sclerotherapy (CLaCS) and compare it with injection sclerotherapy for the treatment of telangiectasia and reticular veins.

METHODS

In this randomized controlled trial, individuals expressing concerns about telangiectasia and reticular veins were recruited for aesthetic treatment. The enrolled patients were prospectively randomized according to the chosen treatment technique. Group A included patients undergoing CLaCS with 70% dextrose, focusing on a single area measuring 20 cm by 20 cm. Group B included patients receiving polidocanol injection sclerotherapy for a single area of the same dimensions.

RESULTS

Group A comprised 195 patients and group B comprised 197 patients. The rates of complete lesion elimination after the first, second, and third treatment sessions were 64.6%, 86.2%, and 100% in group A and 50.3%, 74.1%, and 85.3% in group B, respectively. Group A exhibited a significantly higher complete elimination rate compared with group B at the conclusion of the study (P < .001). Furthermore, group A demonstrated a statistically significant lower incidence of postprocedural pigmentation and other complications compared with group B (P < .001). These findings underscore the enhanced efficacy and safety profile associated with the CLaCS technique using 70% dextrose compared with injection sclerotherapy with polidocanol.

CONCLUSIONS

CLaCS, combining cryo-laser and cryo-sclerotherapy, demonstrated superior efficacy and safety compared with traditional polidocanol sclerotherapy for treating telangiectasia and reticular veins.

摘要

目的

毛细血管扩张症的特征为静脉扩张,常发生于下肢。硬化疗法是治疗这些血管病变的主要方法。激光疗法与温和的硬化剂(作为渗透硬化剂)联合应用,为美容治疗提供了一种增强的方法,旨在优化结果并最小化潜在的不良反应。本研究旨在评估冷冻激光和冷冻硬化疗法(CLaCS)的可行性、疗效和安全性,并将其与注射硬化疗法治疗毛细血管扩张和网状静脉进行比较。

方法

在这项随机对照试验中,招募对毛细血管扩张和网状静脉有美容治疗需求的个体。将纳入的患者按照所选治疗技术进行前瞻性随机分组。A 组接受 70%葡萄糖的 CLaCS,重点治疗 20cm×20cm 的单个区域。B 组接受相同尺寸单一区域的聚多卡醇注射硬化疗法。

结果

A 组包括 195 例患者,B 组包括 197 例患者。在第一次、第二次和第三次治疗后完全消除病变的比例,A 组分别为 64.6%、86.2%和 100%,B 组分别为 50.3%、74.1%和 85.3%。研究结束时,A 组的完全消除率明显高于 B 组(P<0.001)。此外,A 组术后色素沉着和其他并发症的发生率明显低于 B 组(P<0.001)。这些结果表明,与聚多卡醇注射硬化疗法相比,使用 70%葡萄糖的 CLaCS 技术具有更高的疗效和安全性。

结论

CLaCS,结合冷冻激光和冷冻硬化疗法,在治疗毛细血管扩张和网状静脉方面,与传统的聚多卡醇硬化疗法相比,显示出更好的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07d0/11523426/09f818bbb341/gr1.jpg

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