T型管改制大隐静脉剥脱器在大隐静脉剥脱手术中的应用研究

Application of T-Tube Modified Great Saphenous Vein Stripper in Great Saphenous Vein Stripping Surgery

摘要: 目的：本研究旨在创新设计大隐静脉剥脱器，优化其性能，进而提升手术质量，并助力基层医疗资源合理分配。方法：随机选取2024年1月至12月高安市人民医院收治的80例大隐静脉曲张手术患者，分为改良组(55例)和对照组(25例)，对比分析两组在静脉剥脱完整率、手术切口数量、术中出血量、手术时间及术后并发症、随访预后指标上的差异。结果：改良组静脉剥脱完整率(94.55% vs 32.00%)显著高于对照组(P < 0.05)；改良组在手术切口数量个数(4.16 vs 5.76)、术中出血量(45.36 ml vs 70.00 ml)及手术时间(56.27 min vs 68.88 min)方面均低于对照组(P < 0.05)，改良组术后隐神经损伤、血栓事件等并发症总发生率显著低于对照组(P < 0.05)，术后随访6个月曲张静脉复发率更低(P < 0.05)，差异均具有统计学意义。结论：T型管改制大隐静脉剥脱器具有良好性能，实现高静脉剥脱完整率、少手术切口、少出血量、短手术时间及低术后并发症发生率，尤其适用于大直径静脉曲张患者。同时其低成本、高效益的特点，有助力基层医疗资源合理分配，临床应用价值显著。

Abstract: Objective: This study aims to innovatively design a great saphenous vein stripper, optimize its performance, thereby improving the quality of surgery, and facilitating the rational allocation of primary medical resources. Methods: Eighty patients undergoing surgery for great saphenous varicose veins, admitted to Gao’an People’s Hospital between January and December 2024, were randomly selected and divided into a modified group (55 cases) and a control group (25 cases). Comparative analysis was performed between the two groups regarding the complete rate of venous stripping, number of surgical incisions, intraoperative blood loss, operation time, postoperative complications, and follow-up prognostic indicators. Results: The complete rate of venous stripping in the modified group was significantly higher than that in the control group (94.55% vs 32.00%, P < 0.05). The number of surgical incisions (4.16 vs 5.76), intraoperative blood loss (45.36 ml vs 70.00 ml), and operation time (56.27 min vs 68.88 min) in the modified group were all lower than those in the control group (P < 0.05). Additionally, the total incidence of postoperative complications such as saphenous nerve injury and thrombotic events was significantly lower in the modified group than in the control group (P < 0.05), and the recurrence rate of varicose veins at the 6-month postoperative follow-up was also lower in the modified group (P < 0.05). All differences were statistically significant. Conclusion: The modified T-tube great saphenous vein stripper demonstrates favorable performance, achieving a high complete vein stripping rate, fewer surgical incisions, less blood loss, shorter operation time and a lower incidence of postoperative complications. It is especially suitable for patients with large-diameter varicose veins. Meanwhile, its characteristics of low cost and high efficiency contribute to the rational allocation of primary medical resources, indicating significant clinical application value.