A 1470-nm laser combined with foam sclerotherapy in day surgery: a better choice for lower limb varicose veins
A 1470-nm laser combined with foam sclerotherapy in day surgery: a better choice for lower limb varicose veins
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1470nm激光联合泡沫硬化剂治疗日间手术：下肢静脉曲张更好的选择
DOI：
10.1007/s10103-018-2507-8
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发表时间：
2018-09-01
影响因子：
2.1
通讯作者：
Lu, Xinwu
中科院分区：
文献类型：
--
作者：
Zhang, Xing;Wang, Xin;Lu, Xinwu
日间手术越来越多地被临床医生采用。较高波长的激光比较低波长的激光给患者更好的体验，这使得它更适合日间手术。本研究比较了“1470 nm静脉内激光消融（EVLA）联合泡沫硬化日间手术”与“810 nm EVLA +高位结扎联合泡沫硬化住院手术”治疗术后大隐静脉（GSV）功能不全的中短期疗效、术后发病率及患者满意度。在中国上海第九人民医院进行了一项194例患者的单机构历史队列研究。97例患者在日间手术中接受1470 nm EVLA联合泡沫硬化治疗（“1470 nm组”），97例患者在指南推荐的医院手术中接受810 nm EVLA高结扎联合泡沫硬化治疗（“810 nm组”）。术后1-12个月，1470 nm组与810 nm组在GSV闭塞率（均为100%）、并发症发生率和复发率（8.2 vs 11.3%）方面无显著差异。1470 nm组和810 nm组严重并发症发生率分别为0和1.0%。1470 nm组和810 nm组的轻微并发症分别为瘀斑20.6%和18.6%，水肿69.1和63.9%，踝关节周围感觉异常0和3.1%。考虑到患者围手术期舒适度和经济成本，1470 nm组优于810 nm组的优势具有统计学意义。在GSV功能不全的日间手术中，1470 nm EVLA联合泡沫硬化治疗与810 nm EVLA高结扎联合泡沫硬化治疗住院手术疗效相似，且切口少、住院程序少、医疗费用低，更舒适。对于那些害怕或无法住院的病人来说，这可能是一个新的选择。
Day surgery is being more and more adopted by clinicians. Higher wavelength lasers give patients better experience than lower wavelength lasers, which makes it more suitable for day surgery. This study compares the short- and mid-term efficacy, postoperative morbidity, and patient satisfaction of “1470-nm endovenous laser ablation (EVLA) combining foam sclerotherapy in day surgery” with “810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery” on great saphenous vein (GSV) insufficiency postoperatively. A single-institution historical cohort study of 194 patients was performed in Shanghai Ninth People’s Hospital, China. Ninety-seven patients received 1470-nm EVLA combining foam sclerotherapy in day surgery (“1470-nm group”), and 97 patients received 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery recommended by guidelines (“810-nm group”). No significant difference was found between the 1470-nm group and the 810-nm group in terms of GSV occlusion rate (both 100%), complication rate, and recurrence rate (8.2 vs. 11.3%) during the period of 1–12 months after surgery. Serious complications in the 1470-nm group and 810-nm group were 0 and 1.0%. Minor complications in the 1470-nm group and 810-nm group were ecchymosis at 20.6 and 18.6%, edema at 69.1 and 63.9%, and paresthesia around ankle at 0 and 3.1%, respectively. Advantage of the 1470-nm group over the 810-nm group was statistically significant considering the patient perioperative comfort and economic cost. Treatment of 1470-nm EVLA combining foam sclerotherapy in day surgery has similar efficacy as the 810-nm EVLA with high ligation combining foam sclerotherapy in hospital surgery in GSV insufficiency and is more comfortable with less incision, hospitalization procedure, and medical costs. It may be a new option for patients who are afraid or unable to be hospitalized.