关键词: 静脉曲张, 血管成形术, 气囊, 激光辅助, 硬化疗法, 外科手术, 微创性, 点式抽剥术

Abstract: Chen Mingyi, Wu Dongmei, Ying Chuanpeng, Luo Dongsheng, Yang Jianing, Dai Gengwu, Liu Gang, Pan Ning Department of Dermatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People′s Hospital, Chengdu 610072, China Corresponding author: Dai Gengwu, Email: daigw@sina.com 【Abstract】 Objective To investigate therapeutic effects and complications of three kinds of minimally invasive therapies for varicosis of the lower extremities. Methods Totally, 79 patients with 94 affected limbs were enrolled into this study. According to their clinical manifestations, 3 kinds of minimally invasive therapies alone or in combination were selected, including endovenous laser treatment （EVLT） with saphenofemoral ligation and stripping of the great saphenous vein, microphlebectomy, foam sclerotherapy, EVLT with saphenofemoral ligation and stripping of the great saphenous vein + microphle-bectomy, and EVLT with saphenofemoral ligation and stripping of the great saphenous vein + foam sclerotherapy. Physical examination and color Doppler ultrasonography were performed to evaluate the regression and recurrence of varicosis, as well as complications. Meanwhile, dermatology life quality index（DLQI）was used to evaluate the improvement of life quality of the patients after the treatment. Results All the patients were followed up for 1 - 6 months （average, 4.2 months）, and no recurrence was observed. One month after the treatment, all the patients were re-evaluated. Of the 94 affected limbs, 46 （48.9%） were cured, 43 （45.7%） were improved, and 5 （5.3%） were unimproved. Three months after the treatment, 69 patients with 82 limbs completed the re-examination. Of the 82 limbs, 71 （86.6%）were cured, 9 （11.0%） were improved, and 2 （2.4%） were unimproved. Six months after the treatment, 61 patients with 70 limbs completed the follow-up. Of the 70 limbs, 62 （88.6%） were cured, 7 （10.0%） were improved, 1 （1.4%） was unimproved. Repeated-measures analysis of variance revealed that the total DLQI scores before the treatment （9.12 ± 2.87）, one month after the treatment （6.97 ± 2.39）, 3 months after the treatment （5.12 ± 1.96） and 6 months after the treatment （3.69 ± 1.45） significantly differed （F = 328.84, P < 0.01）, and there were significantly differences between any two time points of re-evaluations （all P < 0.01）. In the 79 patients, postoperative complications included subcutaneous ecchymosis （7 patients, 8.9%）, numb sensation in the foot and boot area of the legs （6 patients, 7.6%）, and cord-like subcutaneous induration （3 patients, 3.8%）. Conclusions The three kinds of minimally invasive therapies alone or in combination are all effective for the treatment of varicosis of the lower extremities with rapid recovery. The life quality of patients was obviously improved after the treatment, and the complications were acceptable.

Key words: Varicose veins, Angioplasty, balloon, laser?assisted, Sclerotherapy, Surgical procedures, minimally invasive, Microphlebectomy