Postoperative quality of life in patients with chronic venous insufficiency in lower limbs

Lan ZHANG; Baigen ZHANG; Jiwei ZHANG

ABSTRACT

BACKGROUND:

To evaluate the operative efficacy of chronic venous insufficiency (CVI), we used to emphasize on the improvement of clinical symptom and physical sign without quality of life (QOL).

OBJECTIVE:

To assess the QOL in CVI patients before and after operation.DESTGN Comparative observation, scale evaluation and one-year follow-up.

SETTING:

Department of Vascular Surgery, Renji Hospital, Shanghai Second Medical University.

PARTICIPANTS:

169 CVI patients (209 lower limbs) including 89 males and 80 females with an average age of (56±13) years and disease course of (11 ±3)years, who were treated at Department of Vascular Surgery, Renji Hospital,Shanghai Second Medical University from July 2001 to December 2003, were enrolled. All patients knew the therapeutic scheme and evaluation dimensions.

METHODS:

Three types of operation according to the reflux range and whether deep venous valve imcompetence were carried out. Forty-six subjects with 56 limbs in the superficial venous group received saphenous vein high ligation with stripping the saphenous and varicose vein. Seventy-three subjects with 87 limbs in the perforating venous group underwent both perforating vein ligation and saphenous vein high ligation with stripping the saphenous and varicose vein. Fifty subjects with 66 limbs in the deep venous group received the same operations of group 1 and group 2, in addition to external banding valvuloplasty of the superficial femoral vein. The chronic venous insufficiency questionnaire (CIVIQ) was applied to assess the patients' QOL one week before varicose vein surgery and one year later. The main impairment in QOL focused on 4 dimensions (20 questions), namely pain, physical dimension, social function and psychological dimension. There were five grades to each question (from 1 to 5 points accompany with the serious situation). Total CIVIQ score was sum score of 20 questions. 100 points indicated ideal QOL.MATN OUTCOME

MEASURES:

CIVIQ scores in CVI patients before and after operation.

RESULTS:

All 169 CVI patients were involved in the result analysis. ①Sex differences of CIVIQ The total scores of patients were obviously elevated one year after operation (P ＜ 0.05). There was no significant difference in CIVIQ scores of both sexes (P ＞ 0.05). The total score was markedly elevated after operation (P ＜ 0.05). ②Relationship between CIVIQ scores and operation type No significant difference was found in the superficial venous group, the perforating venous group and the deep venous group (P ＞ 0.05). The total CIVIQ scores in the deep venous group before operation were significantly lower than those in the superficial venous group and the perforating venous group (P ＜ 0.05).

CONCLUSION:

Reasonable operation type can improve the QOL in CVI patients. No significant difference is found in QOL improvement of patients of both sexes.