摘要
目的 探讨泡沫硬化剂对下肢深静脉血栓后遗症性溃疡治疗的效果.方法 下肢深静脉后遗症的静脉性溃疡(CEAP分级C6期)患者28例,实施超声引导监测下溃疡周围曲张静脉泡沫硬化剂注射,通过随访对溃疡的愈合情况及静脉闭合情况进行观察.结果 28例患者共28条肢体接受治疗,技术成功100%,平均每条肢体注射22.5ml泡沫硬化剂(聚多卡醇:空气=1∶4).10例患者(35.7%)需再次泡沫硬化剂注射治疗,术后第1个月5例,第2个月3例,第3个月2例.发现残留/未闭合/再通的血管需再次泡沫硬化剂注射,继续绷带加压包扎或穿弹力袜.术后3个月所有肢体溃疡愈合,15条肢体的溃疡在1个月内愈合,11条肢体溃疡在2个月内愈合,2条肢体3个月时愈合.术后出现1例血栓性静脉炎,1例注射点皮肤炎症反应,经处理1周内好转.无一例下肢深静脉血栓、肺栓塞、休克等并发症出现.结论 泡沫硬化剂注射治疗下肢深静脉血栓后遗症患者的溃疡是安全有效的.
Objective To review the effects of perilesional foam sclerotherapy in leg ulcer patients with postthrombotic syndrome.Methods 28 patients with venous leg ulcers with postthrombotic syndrome were observed.During each treatment session,sclerosing foam was injected with ultrasonic monitoring.They were followed up monthly until all extrafascial veins and the ulcer were closed.Results Closure of the perilesional veins was achieved in all patients with average volume of22.5ml sclerosing foam(1∶4,polidocanol).10 of 28 patients(35.7%)need injections again,5 patients of the first month after surgery,3 patients of the second month,and 2 patients of the third month.All limb ulcers healed within 3 months after injection,ulcers in 15 limbs healed within one month,ulcers in 11 limbs healed within 2 months,and ulcers in 2 limbs healed within 3 months.There were only two complications:anphlebitis and a local inflammatory reaction at an injection site which healed within 1 week.Serious complications did not appear.Conclusion Perilesional sclerotherapy with foam is a safe and efficient therapy for leg ulcer patients with post-thrombotic syndrome.
出处
《浙江临床医学》
2019年第6期820-822,共3页
Zhejiang Clinical Medical Journal
基金
杭州市科技发展计划项目(20160533B26).
