ABSTRACT
Objective To explore the therapeutic effects of endovenous laser ablation (EVLA) combined with percutaneous continuous circumsuture (PCCS) and EVLA in treating severe great saphena varicose. Methods A total of 60 patients with unilateral great saphenous varicose level C5-C6 were randomly divided into control group and experimental group according to the CEAP system. Control group was given EVLA surgery while experimental group was given EVLA+PCCS surgery. Data of operation time, hospital stay, intraoperative blood loss, the rate of ulcer healing, variceal recurrence rate and postoperative complication rate within 6 months after operation were compared between two groups. Results The mean operative time and intraoperative blood loss were lower in the experimental group than those in the control group ( P<0.05). There were no significant differences in hospital stay, ulcer healing rate and recurrence rate between two groups ( P>0.05). No deep venous thrombosis was found after treatment in two groups. The occurrence rates of skin burns and subcutaneous ecchymosis were significantly lower in the experimental group than those in the control group ( P<0.05). There were no significant differences in the incidence rates of other complications between two groups (P>0.05). Conclusion EVLA combined with PCCS in the treatment of severe saphenous varicose veins can significantly shorten the operation time, reduce the amount of bleeding, reduce the incidence rates of skin burns and subcutaneous ecchymosis on the premise of promising cure rate and recurrence rate. Overall, the combination therapy is superior than monotherapy.
ABSTRACT
Objective To explore the therapeutic effects of endovenous laser ablation (EVLA) combined with percutaneous continuous circumsuture (PCCS) and EVLA in treating severe great saphena varicose. Methods A total of 60 patients with unilateral great saphenous varicose level C5-C6 were randomly divided into control group and experimental group according to the CEAP system. Control group was given EVLA surgery while experimental group was given EVLA+PCCS surgery. Data of operation time, hospital stay, intraoperative blood loss, the rate of ulcer healing, variceal recurrence rate and postoperative complication rate within 6 months after operation were compared between two groups. Results The mean operative time and intraoperative blood loss were lower in the experimental group than those in the control group ( P<0.05). There were no significant differences in hospital stay, ulcer healing rate and recurrence rate between two groups ( P>0.05). No deep venous thrombosis was found after treatment in two groups. The occurrence rates of skin burns and subcutaneous ecchymosis were significantly lower in the experimental group than those in the control group ( P<0.05). There were no significant differences in the incidence rates of other complications between two groups (P>0.05). Conclusion EVLA combined with PCCS in the treatment of severe saphenous varicose veins can significantly shorten the operation time, reduce the amount of bleeding, reduce the incidence rates of skin burns and subcutaneous ecchymosis on the premise of promising cure rate and recurrence rate. Overall, the combination therapy is superior than monotherapy.
ABSTRACT
Objective To investigate the clinical significance of serum anti-Saccharomyces cerevisias antibody (ASCA),anti-outer membrane porin C (anti-OmpC),antibody to Pseudomonas fluorescens-associated sequence I2 (anti-I2 )and antibody to bacterial flagellin (anti-CBirl )in the diagnosis and treatment of inflammatory bowel disease (IBD).Methods From 2011 to 2013,87 patients with IBD were enrolled and divided into Crohn′s disease (CD)group (66 cases)and ulcerative colitis (UC)group (21 cases).A total of 62 age and gender matched healthy individuals were enrolled as the control group. Fasting blood samples (2 mL)of the subjects were collected.The expression of ASCA,anti-OmpC,anti-I2 and anti-Cbirl antibodies was detected with enzyme-linked immunosorbent assay (ELISA)kits.The diagnosis value of each antibody in IBD and the differential diagnostic value of in UC and CD were compared by receiver operating characteristic (ROC)curve.Results The area under the curve (AUC)of ASCA between IBD and the healthy control group,between CD group and UC group was 0.580 and 0.512, respectively;the accuracy in diagnosis was low.The AUC of anti-CBirl between IBD and the healthy control group was 0.617.There was no differential diagnosis significance of the other antibodies.The positive rate of ASCA in IBD group was 62.1 % (54/87),which was significantly higher than that in the control group (38.7%,24/62).The positive rates of anti-OmpC and anti-I2 in IBD group was significantly lower than those in the control group and the differences were statistically significant (both P 0.05).The specificity,sensitivity,positive predictive value (PPV)and negative predictive value (NPV)of ASCA in differential diagnosis of CD and UC was 52.4%,66.7%,81 .48% and 33.33%,respectively.The specificity and sensitivity of anti-OmpC,anti-I2 and anti-CBirl in differential diagnosis of CD and UC was 81 .0% to 100.0% and 9.1 % to 37.9%,respectively.The specificity,sensitivity,PPV and NPV of double-positive ASCA and anti-I2 in the diagnosis of CD was 57.1 %,86.4%,82.6% and 50.0%, respectively.The positive rate of ASCA and anti-I2 in CD group was significantly higher than that in UC group (84.8%(56/66)vs 57.1 % (12/21 );χ2 =5 .633,P =0.018 ).Conclusions Positive ASCA has some significance in the diagnosis of patients with IBD in our country.The detection of anti-I2 can help to diagnose ASCA negative CD.Because of low sensitivity and positive rate,anti-OmpC and anti-CBirl have limited value in the diagnosis of IBD and the differential diagnosis of UC and CD in our country.