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[静脉曲张——当前的治疗理念]

[Varicosis-Current treatment concepts].

作者信息

Lisii C, Heckenkamp J

机构信息

Klinik für Gefäßchirurgie und endovaskuläre Chirurgie, Marienhospital Osnabrück, Niel-Stensen Kliniken, Bischofstraße, 49074, Osnabrück, Deutschland.

出版信息

Chirurgie (Heidelb). 2024 May;95(5):415-426. doi: 10.1007/s00104-024-02063-4. Epub 2024 Apr 10.

Abstract

Varicosis is a chronic progressive disease characterized by varicose veins of the lower extremities. Pain, swelling and heaviness of the legs are typical symptoms. These symptoms are caused by a pathological venous reflux, arising from a weakness of the vein wall and progressive venous insufficiency. The indications for invasive surgery are the symptomatic clinical, etiological, anatomical, pathophysiological (CEAP) stages C2s-C6. Compression therapy and venoactive drugs can be recommended for conservative therapy. When it comes to surgical treatment conventional open vein surgery is associated with the best long-term results. Endovenous thermal ablation is associated with few postoperative complications and favors earlier mobilization of the patient. Sclerotherapy has become established with good clinical results for the ablation of reticular and telangiectatic veins, for recurrences and complicated vein anatomy.

摘要

静脉曲张是一种以下肢静脉曲张为特征的慢性进行性疾病。腿部疼痛、肿胀和沉重感是典型症状。这些症状由病理性静脉反流引起,其源于静脉壁薄弱和进行性静脉功能不全。侵入性手术的适应证为有症状的临床、病因、解剖、病理生理(CEAP)分期C2s - C6。保守治疗可推荐使用压迫疗法和静脉活性药物。在手术治疗方面,传统的开放式静脉手术具有最佳的长期效果。腔内热消融术后并发症较少,有利于患者早期活动。硬化疗法已被确立,对于网状和毛细血管扩张性静脉消融、复发以及复杂的静脉解剖结构具有良好的临床效果。

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