RESUMO
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.
RESUMO
Objective To evaluate the therapeutic effect of endovenous laser ablation (ELA) combined with foam sclerotherapy (FS) and mucopolysaccharide polysulfate (MP)cream on stasis dermatitis.Methods From December 2015 to May 2017,52 patients with 60 lesional limbs were enrolled from Department of Dermatology of Sichuan Provincial People's Hospital.The 60 lesional limbs were randomly and equally divided into 3 groups by a random number table and remainder grouping:combination group,MP group and control group.All the 3 groups were firstly treated with ELA in the main great saphenous vein.Then,the combination group was treated with FS followed by topical MP cream for 4 weeks.After the laser therapy,the MP group was treated with topical MP cream for 4 weeks,and the control group was treated with topical mometasone furoate cream alone for 4 weeks.The eczema area and severity index (EASI) and visual analogue scale (VAS) for itching scores in the above 3 group were recorded before treatment and 4 weeks after treatment.Statistical analysis was done by paired t-test for comparisons before and after treatment,one-way analysis of variance (ANOVA) for intergroup comparison,and least significant difference (LSD)-t test for multiple comparisons.Results No significant difference was observed before treatment among the combination group,MP group and control group in the EASI (9.64 ± 4.58,9.94 ± 4.18,9.50 ± 4.41 respectively,F =0.052,P ＞ 0.05) or VAS scores (7.25 ± 1.29,7.50 ± 1.19,7.45 ± 1.32 respectively,F =0.218,P ＞ 0.05).After 4-week treatment,the combination group,MP group and control group all showed significantly decreased EASI (3.54 ± 1.57,5.86 ± 2.39,7.04 ± 2.75 respectively) and VAS scores (2.35 ± 0.67,3.85 ± 0.67,4.65 ± 1.23 respectively) compared with those before treatment (t =4.30-18.80,all P ＜ 0.05).After 4-week treatment,the EASI score was significantly lower in the combination group than in the MP group and control group (both P ＜ 0.05),while there was no significant difference between the MP group and control group (P ＞ 0.05).Additionally,the VAS score was significantly lower in the combination group than in the MP group and control group (both P ＜ 0.05),as well as in the MP group than in the control group (P ＜ 0.05).Conclusions ELA combined with FS and topical MP cream shows better short-term efficacy for the treatment of stasis dermatitis compared with ELA combined with topical MP cream or mometasone furoate cream.The combination with topical MP cream is superior to that with topical mometasone furoate cream in improving itching.The long-term efficacy needs to be observed further.