激光腔内闭合联合泡沫硬化剂注射术在下肢静脉曲张伴溃疡中的疗效分析

Analysis of Therapeutic Effect of Laser Intracavitary Closure Combined with Foam Hardener Injection for Varicose Veins of the Lower Extremities with Ulcers

摘要: 目的：观察激光腔内闭合联合泡沫硬化剂注射术在下肢静脉曲张伴溃疡患者中的应用效果。方法：选取2022年1月至2023年6月收治的主诊断为“下肢静脉曲张伴溃疡”的患者100例，按照患者治疗方式将其分为实验组(激光联合泡沫硬化剂) 55例和对照组(传统手术) 45例。对比两组患者手术时间、出血量、隐神经损伤、术后住院时间、术后患肢疼痛、住院期间费用及术后1年随访等情况。结果：在住院情况中，激光联合泡沫硬化剂组在手术时间、术中出血、隐神经损伤、术后住院时间、术后患肢疼痛方面均明显小于传统手术组(P均<0.05)。术后1年随访，激光联合泡沫硬化剂组在术后切口愈合情况、术后1年溃疡面积及溃疡好转情况方面均优于传统手术组(P均<0.05)。两组在术后深静脉血栓形成、术后皮肤色素沉着、术后1年再次干预的费用和皮肤瘙痒、浅静脉炎等其他并发症方面无统计学意义。在住院费用中，激光联合泡沫硬化剂组的总费用、药品费用及比例、检查检验费用、护理及治疗费用方面优于对照组(P均<0.05)，两组手术及耗材费用以及相关比例方面，无统计学意义。结论：激光联合泡沫硬化剂对于下肢静脉曲张伴溃疡患者能缩短患者住院、手术及术后溃疡愈合时间，减少患者隐神经损伤、术后切口感染及肢体疼痛等并发症，缓解患者住院总费用、检查检验费用、护理及治疗费等经济负担，值得临床推广应用。

Abstract: Objective: To observe the effect of laser cavity closure combined with foam hardener injection in patients with varicose veins and ulcers of the lower extremities. Methods: A total of 100 patients with the main diagnosis of “varicose veins of lower extremity with ulcer” were selected from January 2022 to June 2023 and divided into the experimental group (55 cases with laser combined with foam hardener) and the control group (45 cases with traditional surgery) according to the treatment methods. Operation time, blood loss, saphenous nerve injury, postoperative hospital stay, postoperative pain of the affected limb, hospitalization cost and 1-year postoperative follow-up were compared between the two groups. Results: In terms of hospitalization, the operative time, intraoperative bleeding, saphenous nerve injury, postoperative hospitalization time and postoperative pain of the affected limb in the laser combined with foam hardener group were significantly lower than those in the traditional surgery group (all P < 0.05). After 1 year of follow-up, the wound healing, ulcer area and ulcer improvement in the laser combined with foam hardener group were better than those in the traditional surgery group (P < 0.05). There was no significant difference between the two groups in postoperative deep vein thrombosis, postoperative skin pigmentation, the cost of re-intervention 1 year after surgery, or other complications such as skin pruritic and superficial phlebitis. In terms of hospitalization costs, the total cost, drug cost and proportion, inspection cost, nursing and treatment cost of the laser combined with foam hardener group were better than those of the control group (P < 0.05), but there was no statistical significance in terms of operation and consumables cost and related proportion between the two groups. Conclusion: Laser combined with foam hardener can shorten the time of hospitalization, operation and postoperative ulcer healing for patients with varicose veins of the lower limbs, reduce the complications of saphenous nerve injury, postoperative incision infection and limb pain, and alleviate the economic burden of total hospitalization costs, inspection costs, nursing costs, and treatment costs for patients, which is worth clinical promotion and application.