中国实用外科杂志

中国实用外科杂志 ›› 2021, Vol. 41 ›› Issue (12): 1365-1368.DOI: 10.19538/j.cjps.issn1005-2208.2021.12.11

• 专题笔谈 • 上一篇    下一篇

双下肢静脉曲张治疗策略

马    博，刘    鹏   

  1. 中日友好医院心脏血管外科，北京100029
  • 出版日期:2021-12-01 发布日期:2021-12-06

  • Online:2021-12-01 Published:2021-12-06

摘要： 双侧下肢静脉曲张是较常见的下肢慢性静脉疾病，其治疗策略随着手术技术和微创技术的发展也随之发生改变。传统的高位结扎剥脱术创伤较大，在治疗双下肢静脉曲张病人时往往采用分期手术的策略，目前通过选择合适的病人以及改变手术策略可实现在不增加并发症风险的情况下完成双下肢静脉曲张的同期剥脱处理。随着腔内射频闭合术（RFA）和腔内激光灼闭术（EVLA）的推广应用，这类热损伤闭合静脉主干的微创治疗方法能更好地应用于双下肢静脉曲张的同期处理，既有理想的主干闭合率，也能在降低并发症、改善下肢静脉相关症状、提高病人生活质量方面有较好的效果。腔内机械化学闭合术（MOCA）和氰基丙烯酸盐黏合剂注射闭合作为非热闭合的腔内微创技术，在双下肢静脉治疗方面可能会有一定的前景。

关键词: 下肢静脉曲张, 高位结扎剥脱, 射频闭合术, 腔内激光灼闭术

Abstract: The strategy for treating bilateral varicose veins        MA Bo, LIU Peng. Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
Corresponding author：LIU Peng, E-mail:liupeng5417@163.com
Abstract    Bilateral varicose veins of lower limbs are common chronic venous disease.The strategy for treating bilateral varicose veins was improved as the development of surgical technique and endovenous treatment.The traditional stripping surgery was chosen to treat bilateral varicose veins as a staged strategy.However，the complications could be acceptable for concurrent bilateral stripping when the appropriate patients were chosen.The radiofrequency ablation（RFA）and endovenous laser ablation（EVLA）were more suitable for concurrent bilateral strategy.The RFA and EVLA had the rational closure rate，fewer complications and improvement of quality of life.Mechanochemical ablation（MOCA）and cyanoacrylate glue closure were non-thermal ablation technique.They could be applied for treating bilateral varicose veins.

Key words: varicose vein, high ligation and stripping, radiofrequency ablation, endovenous laser ablation