The Clinical Effective Analysis Of Three Combined Surgical Treatment On Great Saphenous Vein Varicositye

Objective:To evaluate treatment effectiveness of three surgical treatments including endovenous laser ablation,varus total exfoliation,double-wall and double-lumen varus occlusion with percutaneous transilluminated powered phlebectomy on great saphenous varicose veins.Methods:261 Patients with great saphenous varicose veins(261 legs,all of them affected unilateral limbs)admitted to the Department of Vascular Surgery of the Fourth Affiliated Hospital of Kunming Medical University from Janury 2019 to December 2019 were retrospected,and according to the surgical treatment,all patients were divided into three groups:88 in group A(adopted endovenous laser ablation combined with transilluminated powered phlebectomy of calf varicose veins),87 in group B(adopted varus total exfoliation combined with transilluminated powered phlebectomy of calf varicose veins),86 in group C(adopted double-wall and double-lumen varus occlusion combined with transilluminated powered phlebectomy of calf varicose veins).This thesis will investigate the treatment effectiveness of the three operations:firstly,the differences among intraoperative blood loss,operation time,postoperative hospitalization time and hospitalization cost in these three combined surgical operations are analyzed.Secondly,the differences of postoperative complications such as postoperative pain of the affected limb,subcutaneous ecchymosis,subcutaneous hematoma,incision hemorrhage,skin infection,skin necrosis,skin burn,swelling of the affected limb,paresthesia and/or numbness,deep vein thrombosis and/or pulmonary embolism,lymphorrhagia,superficial phlebitis and subcutaneous induration are compared.Results:All patients did not have the following symptoms:subcutaneous hematoma,incision hemorrhag,skin infection,skin necrosis,deep venous thrombosis and/or pulmonary embolism,lymphorrhagia.All patientsunderwent vascular ultrasound 1 month after surgery,there was no reflective soundin thearea of great saphenous veinand no local recanalization clinical symptom.1.Indexes of hospitalization.The average postoperative hospitalization time:Group A(3.14±0.68)d,group B(3.80±0.68)d,group C(3.83±0.83)d.and the average postoperative hospitalization time in group A was significantly shorter than ingroup B and C(P<0.05);The average hospitalization cost;group A(9700.26±806.45)yuan,group B(6932.46±758.75)yuan),group C(6894.94±708.63)yuan,and the average hospitalization cost ingroup A was significantly higher than in group Band C(P<0.05).2.Indexes of Intraoperation.Mean operation time(MOT):Group A(61.31±22.42)min,group B(52.31±17.94)min,group C(51.88±15.77)min),and MOT in group A was obviously higher than group B and C(P<0.05);Mean bleeding volume:group A(18.47±7.63)ml,group B(26.03±21.43)ml,group C(23.55±14.03)ml,B>C>A(P<0.05).3.Indicators 3 days after operation.Syndrome:The pain rate,subcutaneous ecchymosis rate,skin burn rate,paresthesiaand/or numbness rate in group B were obviously higher than those in group A and C(P<0.05).The difference in swelling swelling of the affected limb was not statistically significance(P>0.05);score of pain score 3 days after surgery:the average pain score gradually decreased with time after surgery,and the average pain score was group B>C>A(P<0.05).4.Indicators 10 days after operation.Pain rate,subcutaneous ecchymosis rate,paresthesia and/or numbness rate of the affected limb in group B were significantly higher than those in group A and C(P<0.05),and there was no statistically significance in skin burn(P>0.05).5.Indexes 30days after operation.Pain rate,paresthesiaand/or numbness of the affected limb were significantly lower than the corresponding rates of 3 and 10 days after operation,but the pain rate,paresthesiaand/or numbness of the affected limb in group B werestill higher than those in group A and C(P<0.05);there was no superficial phlebitis in group B,the rate of superficial phlebitis in group A and C were respectively7.23%and 3.61%,there were no statistical significance between A and C(P>0.05);the rate of subcutaneous induration in the three groups wererespectively 12.04%,1.17%and 7.23%,and group A and C were significantly higher than group B(P<0.05).Conclusions:The combined operationof double-wall and double-lumen varus occlusion are effective with minimally invasive,and few complications,less expensive than the combined operationof endovenous laser ablation in treatment expense.