超声引导下腔内微波消融术治疗下肢静脉曲张的临床应用研究进展
Advances in Clinical Application of Ultrasound-Guided Endovenous Microwave Ablation in the Treatment of Varicose Veins of Lower Extremity
DOI: 10.12677/acm.2025.15102915, PDF,    科研立项经费支持
作者: 任 娜, 单晓露, 魏鲁飞, 李 燕：潍坊市人民医院血管外科，山东 潍坊；刘宗芬：山东第二医科大学附属医院浮烟山院区血管介入科，山东 潍坊；吴凯凯：山东第二医科大学附属医院急诊科，山东 潍坊；刘聿秀*：山东第二医科大学护理学院，山东 潍坊
关键词: 腔内微波消融技术；静脉曲张；下肢；超声；Endovenous Microwave Ablation； Varicose Vein； Lower Extremity； Ultrasonography
摘要: 下肢静脉曲张作为常见、高发的下肢血管疾病，其微创治疗技术革新始终是临床研究热点。超声引导下腔内微波消融术(EMA)作为新兴热消融技术，通过导管发射能量微波产生精准热效应，在超声实时监控下实现靶向血管闭合，为静脉曲张治疗提供了创新性解决方案，其临床应用日益广泛。本文对EMA技术进行全面梳理，总结了其最新的研究进展，对于指导临床医生选择合适的治疗方案、规范操作流程以及认识该技术的优缺点具有重要的现实意义。
Abstract: As a common and highly prevalent vascular disease of the lower limbs, the innovation of minimally invasive treatment techniques for varicose veins has consistently been a focus of clinical research. As an emerging thermal ablation technology, Endovenous Microwave Ablation (EMA) under ultrasound guidance delivers energy via a catheter to generate precise thermal effects, achieving targeted vessel closure under real-time ultrasonic monitoring. This approach provides an innovative solution for the treatment of varicose veins, and its clinical applications are increasingly widespread. This article comprehensively reviews EMA technology and summarizes the latest research progress, which holds significant practical implications for guiding clinicians in selecting appropriate treatment options, standardizing operational procedures, and understanding the advantages and limitations of this technique.
文章引用：任娜, 刘宗芬, 吴凯凯, 单晓露, 魏鲁飞, 李燕, 刘聿秀. 超声引导下腔内微波消融术治疗下肢静脉曲张的临床应用研究进展[J]. 临床医学进展, 2025, 15(10): 1519-1524. https://doi.org/10.12677/acm.2025.15102915

参考文献

[1] 莫伟, 李海燕. 外周血管疾病介入护理学[M]. 北京: 人民卫生出版社, 2017: 598.
[2] Davies, A.H. (2019) The Seriousness of Chronic Venous Disease: A Review of Real-World Evidence. Advances in Therapy, 36, 5-12. [Google Scholar] [CrossRef] [PubMed]
[3] 金雄伟, 李宏帅, 唐石驹, 等. 大隐静脉高位结扎加腔内微波消融联合泡沫硬化剂治疗下肢静脉曲张的临床研究[J]. 中国实用医药, 2020, 15(35): 51-53.
[4] Fan, P., Cong, L., Dong, J., Han, Y. and Yang, L. (2022) Comparison of 5-Year Outcomes and Quality of Life between Endovenous Laser (980 nm) and Microwave Ablation Combined with High Ligation for Varicose Veins. Frontiers in Surgery, 9, Article 1022439. [Google Scholar] [CrossRef] [PubMed]
[5] Nyamekye, I.K. (2018) A Practical Approach to Tumescent Local Anaesthesia in Ambulatory Endovenous Thermal Ablation. Phlebology: The Journal of Venous Disease, 34, 238-245. [Google Scholar] [CrossRef] [PubMed]
[6] Machin, M., Salim, S., Tan, M., et al. (2021) Surgical and Non-Surgical Approaches in the Management of Lower Limb Post-Thrombotic Syndrome. Expert Review of Cardiovascular Therapy, 19, 191-200. [Google Scholar] [CrossRef] [PubMed]
[7] 刘玉辉, 何光伦. 超声引导下微波消融治疗下肢静脉曲张术后复发性溃疡17例[J]. 武警医学, 2019, 30(4): 345-347.
[8] 董利刚, 夏兰兰, 李安泉. 静脉造影和双功彩超诊断下肢静脉疾病协同性和局限性的分析[J]. 齐齐哈尔医学院学报, 2009, 30(20): 2494-2495.
[9] 郭洁, 姚志勇. 超声引导下微波消融术治疗下肢静脉曲张的研究进展[J]. 实用老年医学, 2022, 36(2): 118-120.
[10] Kalaij, A.G.I., Zahrani, S., Saputro, K.B., Suwana, A.G., Taofan, Indriani, S., et al. (2025) Efficacy and Safety of Endovenous Microwave Ablation versus Endovenous Laser Ablation for Varicose Veins in Chronic Great Saphenous Vein Insufficiency: A Meta-Analysis. Annals of Vascular Surgery, 114, 163-174. [Google Scholar] [CrossRef] [PubMed]
[11] 何利民, 毛建强, 邢旭峰, 等. 腔内微波联合泡沫硬化剂治疗下肢静脉曲张[J]. 中国中西医结合外科杂志, 2018, 24(2): 218-220.
[12] Yang, L., Wang, X., Wei, Z., Zhu, C., Liu, J. and Han, Y. (2020) The Clinical Outcomes of Endovenous Microwave and Laser Ablation for Varicose Veins: A Prospective Study. Surgery, 168, 909-914. [Google Scholar] [CrossRef] [PubMed]
[13] 杜学晴, 李煜, 汤浩国, 等. 超声引导下微波消融治疗下肢静脉曲张的效果探讨[J]. 影像研究与医学应用, 2024, 8(18): 182-184.
[14] 陈乾, 严佳, 李敏毓, 等. “从络论治”视角探讨中医外治法与循序减压法治疗下肢静脉曲张的研究进展[J]. 时珍国医国药, 2019, 30(3): 677-678.
[15] 靳立强, 郭海涛, 韩书明. 复方黄柏液涂剂外敷联合泡沫硬化治疗下肢静脉曲张性溃疡疗效及其对TNF-α、IL-6、CRP水平的影响[J]. 中华中医药学刊, 2023, 41(11): 250-253.
[16] 刘奎, 奉海军, 曹少博, 等. 去腐生新膏联合庆大霉素软膏治疗慢性下肢静脉曲张溃疡感染及对HIF-1α/VEGF信号通路的影响[J]. 中华医院感染学杂志, 2024, 34(24): 3764-3768.
[17] 赵亮, 熊伟. 补阳还五汤联合火针刺络法在气虚血瘀型下肢静脉曲张术后应用的临床观察[J]. 时珍国医国药, 2021, 32(8): 1943-1944.
[18] 杨晓玉, 许卫国. 微波消融联合泡沫硬化术与射频消融联合泡沫硬化术治疗下肢静脉曲张的疗效对比[J]. 广州医药, 2023, 54(2): 33-37.
[19] Yang, L., Wang, X.P., Su, W.J., Zhang, Y. and Wang, Y. (2013) Randomized Clinical Trial of Endovenous Microwave Ablation Combined with High Ligation versus Conventional Surgery for Varicose Veins. European Journal of Vascular and Endovascular Surgery, 46, 473-479. [Google Scholar] [CrossRef] [PubMed]
[20] Zhang, L., Lin, Y., Geng, C., Huang, W., Yang, Q., He, C., et al. (2024) Safety and Efficacy of Endovenous Microwave Ablation for Treatment of Varicose Veins of the Lower Limbs in China: A Prospective Registered Clinical Trial. Vascular, 33, 1011-1019. [Google Scholar] [CrossRef] [PubMed]
[21] Zhang, J., Lin, Y., Zhang, L., et al. (2025) Comparison of One-Year Outcomes and Quality of Life between Radiofrequeney Ablation and Mierowave Ablation in the Treatment of Lower Extremity Varieose Veins: A Retrospective Cohort Study. Phlebology, 40, 39-46. [Google Scholar] [CrossRef] [PubMed]
[22] 罗海平. 射频消融术与传统分段剥脱切除术对下肢浅静脉曲张的效果差异分析[J]. 生物医学工程学进展, 2025, 46(1): 42-48.
[23] Mao, J., Zhang, C., Wang, Z., Gan, S. and Li, K. (2012) A Retrospective Study Comparing Endovenous Laser Ablation and Microwave Ablation for Great Saphenous Varicose Veins. European Review for Medical and Pharmacological Sciences, 16, 873-877.
[24] Nesbitt, C., Bedenis, R., Bhattacharya, V. and Stansby, G. (2014) Endovenous Ablation (Radiofrequency and Laser) and Foam Sclerotherapy versus Open Surgery for Great Saphenous Vein Varices. Cochrane Database of Systematic Reviews, No. 7, CD005624. [Google Scholar] [CrossRef] [PubMed]
[25] Lu, W., Jiang, J., Wu, H., Chen, G., Zhang, Q. and Yang, G. (2024) Endovenous Microwave Ablation versus Laser Ablation for Small Saphenous Vein Varicosis. Advances in Therapy, 41, 2342-2351. [Google Scholar] [CrossRef] [PubMed]
[26] Zhao, N., Guo, H., Zhang, Y., Hu, X., He, J., Wang, D., et al. (2024) Comparison of Endovenous Microwave Ablation versus Radiofrequency Ablation for Lower Limb Varicose Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 12, Article ID: 101662. [Google Scholar] [CrossRef] [PubMed]
[27] Yang, X., Li, J., Bai, X., Zhou, L. and Xu, W. (2024) Endovenous Microwave Ablation versus Radiofrequency Ablation for the Treatment of Lower Limb Varicose Veins. Annals of Vascular Surgery, 98, 301-308. [Google Scholar] [CrossRef] [PubMed]
[28] Li, Y., Wu, W., Li, Y., Li, J. and Sun, M. (2022) Efficacy and Safety of Endovenous Microwave Ablation versus Laser Ablation for Great Saphenous Vein Varicosis: Study Protocol for a Multicentre, Randomised Controlled Non-Inferiority Trial. BMJ Open, 12, e059213. [Google Scholar] [CrossRef] [PubMed]

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