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目的评价X线监视下经导管注入无水乙醇治疗下肢静脉曲张的远期疗效及安全性。资料与方法对69例(78条患肢)下肢静脉曲张患者行穿刺或切开内踝上方大隐静脉插入导管,在X线及对比剂监视下注入无水乙醇栓塞治疗。结果 75条(96.%)患肢均一次性栓塞成功;75条患肢于术后7天～3个月多普勒超声显示栓塞的大隐静脉未探及血流信号。随访3～55个月(平均31.2个月),术后3～7天曲张的静脉均塌陷,2～3周临床症状明显减轻或消失,7条小腿溃疡于术后4～6周愈合。13例(18.8%)术后出现咳嗽、胸闷,5～10 min内消失;7条患肢(9.0%)术后肢体出现迟发性感觉异常,2～3周内恢复正常;31条(39.7%)患肢术后第2天出现轻度肿胀,1～2周内均消失;3条(3.8%)患肢于术后12个月内出现小腿浅静脉局限性轻度曲张,无1例深静脉血栓等严重并发症发生。结论经大隐静脉插管注入无水乙醇治疗下肢静脉曲张安全、并发症少,远期疗效肯定;有望成为下肢静脉曲张新的治疗方法之一。
Objective To evaluate the long-term efficacy and safety of catheterized absolute ethanol in the treatment of varicose veins of lower extremities under X-ray monitoring. Materials and Methods 69 patients (78 limbs) with varicose veins underwent puncture or incision of the saphenous vein at the superior medial malleolus, and received absolute ethanol embolization under the monitoring of X-ray and contrast medium. Results A total of 75 limbs (96.%) were successfully embolized with a single embolization. Doppler echocardiography was performed on 75 limbs 7 days to 3 months after operation. The embolized saphenous vein was not detected and the blood flow signal was detected. All the patients were followed up for 3 to 55 months (mean, 31.2 months). The varicose veins were collapsed 3 to 7 days after operation. The clinical symptoms of 2 to 3 weeks were significantly reduced or disappeared. Seven calf ulcers healed 4 to 6 weeks after operation. 13 cases (18.8%) had cough and chest distress after operation, and disappeared in 5 to 10 minutes. Delayed sensory abnormalities occurred in limbs of 7 affected limbs (9.0%), returned to normal within 2 to 3 weeks, and 31 (39.7 %) Had mild swelling on the second postoperative day and disappeared within 1 to 2 weeks. Three (3.8%) limbs showed slight varicose of varicose vein within 12 months after operation and none Serious complications such as deep venous thrombosis occur. Conclusions The intravenous infusion of intravenous infusion of large saphenous vein in the treatment of varicose veins of lower extremities is safe and has few complications and long-term curative effect. It is expected to become a new treatment for varicose veins of the lower extremities.