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 explore the clinical efficacy and satety of LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities.Methods The clinical data of 105 patients treated by traditional surgery (surgery group) and 113 patients with endovascular laser treatment (EVLT) combined with polidocanol (combination group) were retrospectively analyzed from Apr 2013 to Apr 2015.Results The operative time [(50 ± 12) min vs.(70 ±10)min] and blood loss [(19 ± 6)ml vs.(41 ± 8)ml] between combination group and surgery group were significantly different (P ＜ 0.05).The rate of complications in surgery group was significantly higher than that in the combination group[15.2％ (16/105)vs.6.3％ (7/113),x2 =4.717,P =0.030].The overall 1',2' and 3 year follow-up rate was 85.3％ (186/218),76.6％ (167/218),and 60.6％ (132/218).The average follow up was (20 ± 13)months.No significant difference existed in the rate of recurrence [0 vs.3.5％(4/113),x2 =3.786,P=0.123] between the two groups.Conclusions EVLT combined with foam sclerotherapy is as effective as surgery,while resulting in less complications,less invasive,safer and more effective for the treatment of varicose veins of the lower extremities.