Tretbar L L
Department of Clinical Surgery, University of Missouri-Kansas City School of Medicine, USA.
Dermatol Surg. 1996 Jan;22(1):78-80. doi: 10.1111/j.1524-4725.1996.tb00575.x.
Bleeding is a well-recognized but seemingly uncommon complication of varicose vein disease. Some deaths have occurred in which bleeding developed from vessels in the base of chronic venous ulcers.
To elucidate a more common type of venous bleeding that can be identified and treated by an experienced sclerotherapist.
The records of a group of patients with bleeding superficial phlebectasias, primarily on the feet and ankles, are reviewed. All patients received injection sclerotherapy after the initial bleeding episode. A comparison was made between those patients whose bleeding points were sutured in the emergency department and those who were treated only with compression.
Suture-ligation of the bleeding site delayed healing when compared with simple compression. Concomitant injection sclerotherapy proved to be a successful and permanent method of treating these veins. No recurrent bleeding developed in any of the patients, even in those with previous episodes of bleeding.
Initial treatment of the bleeding blue bleb requires only compression of the tiny open vessel. Later injection sclerotherapy provides a permanent method of obliterating the thin-walled veins and prevents future bleeding. It is essential to treat the entire incompetent venous system as well as the bleeding site itself.
出血是静脉曲张疾病中一种广为人知但似乎并不常见的并发症。曾有一些死亡病例，出血源自慢性静脉溃疡底部的血管。
阐明一种经验丰富的硬化治疗师能够识别并治疗的更常见的静脉出血类型。
回顾一组主要发生在足部和脚踝的浅表静脉扩张出血患者的记录。所有患者在首次出血事件后均接受了注射硬化治疗。对在急诊科缝合出血点的患者与仅接受压迫治疗的患者进行了比较。
与单纯压迫相比，出血部位的缝合结扎延迟了愈合。同时进行注射硬化治疗被证明是治疗这些静脉的一种成功且永久性的方法。所有患者均未出现复发性出血，即使是那些既往有出血史的患者。
对出血性蓝色水疱的初始治疗仅需压迫微小的开放血管。后期注射硬化治疗提供了一种永久性闭塞薄壁静脉并防止未来出血的方法。治疗整个功能不全的静脉系统以及出血部位本身至关重要。
