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治疗大隐静脉反流合并节段性腘静脉反流后的临床疗效。

Clinical outcomes after treatment of incompetent saphenous vein combined with segmental popliteal vein reflux.

机构信息

Department of Thoracic and Cardiovascular Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

出版信息

J Vasc Surg Venous Lymphat Disord. 2024 Nov;12(6):101918. doi: 10.1016/j.jvsv.2024.101918. Epub 2024 May 27.

Abstract

OBJECTIVE

This study aimed to evaluate whether differences exist in the quality of life changes and complication rates after treatment of incompetent saphenous vein (ISV) based on the presence of segmental popliteal vein reflux (SPVR).

METHODS

Patients who underwent treatment for ISV from July 2016 to July 2021 were included and divided into two groups: patients without deep venous reflux (DVR) and patients with SPVR. Patients with axial DVR, a history of deep vein thrombosis, a history of orthopedic surgery, previous venous treatment, and no postoperative follow-up were excluded from the study. Duplex ultrasound examination was performed preoperatively and at 6 and 12 months postoperatively.

RESULTS

The study included 233 patients (398 limbs), and 50 (64 limbs) had SPVR. Differences were not observed in gender, age, body mass index, distribution of clinical class according to Clinical-Etiology-Anatomy-Physiology classification, laterality, treatment method, and preoperative Venous Clinical Severity Score or Aberdeen Varicose Vein Questionnaire scores between the two groups with SPVR or without DVR. Furthermore, the Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores at 6 and 12 months postoperatively were improved in both groups, although without significant differences. A significant difference was not observed in the rate of postoperative complications between the groups based on the presence of SPVR (1.8% vs 1.6%: P = .896). The SPVR improvement rate after ISV treatment was 25% (16/64), and patient-reported outcomes in patients combined with SPVR improved independent of treatment modality, saphenous vein treatment section, and postoperative SPVR improvement.

CONCLUSIONS

Complication rates and clinical outcomes after ISV treatment did not differ in the presence of SPVR. In patients with SPVR, after ISV treatment, quality of life improved regardless of treatment modality, saphenous vein treatment section, and postoperative SPVR improvement.

摘要

目的

本研究旨在评估基于节段性腘静脉反流(SPVR)的存在,治疗功能不全隐静脉(ISV)后生活质量变化和并发症发生率是否存在差异。

方法

纳入 2016 年 7 月至 2021 年 7 月期间接受 ISV 治疗的患者,并分为两组:无深静脉反流(DVR)患者和 SPVR 患者。排除轴向 DVR、深静脉血栓形成史、骨科手术史、既往静脉治疗史和无术后随访的患者。术前及术后 6 个月和 12 个月行双功能超声检查。

结果

本研究共纳入 233 例患者(398 条肢体),其中 50 例(64 条肢体)存在 SPVR。在性别、年龄、体重指数、临床分类分布(根据临床-病因-解剖-生理学分类)、侧别、治疗方法、术前静脉临床严重程度评分或 Aberdeen 静脉曲张问卷评分方面,存在 SPVR 与无 DVR 的两组间无差异。此外,两组术后 6 个月和 12 个月时静脉临床严重程度评分和 Aberdeen 静脉曲张问卷评分均得到改善,但无统计学差异。两组间基于 SPVR 存在的术后并发症发生率无差异(1.8%比 1.6%:P=.896)。ISV 治疗后 SPVR 改善率为 25%(16/64),合并 SPVR 的患者的患者报告结局改善与治疗方式、隐静脉治疗节段和术后 SPVR 改善无关。

结论

在存在 SPVR 的情况下,ISV 治疗后的并发症发生率和临床结果无差异。在存在 SPVR 的患者中,无论治疗方式、隐静脉治疗节段和术后 SPVR 改善如何,ISV 治疗后生活质量均得到改善。

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本文引用的文献

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The Effect of Saphenous Vein Ablation on Combined Segmental Popliteal Vein Reflux.大隐静脉消融对腘静脉节段性反流合并症的影响。
Korean J Thorac Cardiovasc Surg. 2018 Oct;51(5):338-343. doi: 10.5090/kjtcs.2018.51.5.338. Epub 2018 Oct 5.
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Deep venous reflux definitions and associated clinical and physiological significance.深静脉反流的定义及其相关的临床和生理意义。
J Vasc Surg Venous Lymphat Disord. 2013 Oct;1(4):325-32. doi: 10.1016/j.jvsv.2012.12.003. Epub 2013 May 31.

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