Валеология: Здоровье, Болезнь, Выздоровление. 2019; : 43-48
СРАВНИТЕЛЬНЫЙ АНАЛИЗ РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ ВАРИКОЗНОЙ БОЛЕЗНИ НИЖНИХ КОНЕЧНОСТЕЙ ТРАДИЦИОННОЙ ФЛЕБЭКТОМИЕЙ И ГИБРИДНЫМ МЕТОДОМ.
Аннотация
Изучение результатов лечения варикозной болезни является актуальным вопросом в связи с широкой распространенностью данной патологии. Целью данного исследования было сравнение результатов лечения пациентов с варикозной болезнью нижних конечностей после традиционной флебэктомии и гибридного лечения.
Материалы и методы. Материалом для исследования являлись пациенты, получавшие хирургическое лечение по поводу варикозной болезни нижних конечностей, относящиеся ко второму и третьему
клиническому классу по CEAP (C2,Ep,As,Pr,n., C3,Ep,As,Pr,n.) В первую группу относились пациенты, получавшие хирургическое лечение по поводу ВБНК в объеме традиционной флебэктомии, – 132 человека.
Во вторую группу относились пациенты после гибридного лечения – 116 человек.
Результаты. Частота осложнений в раннем послеоперационном периоде не имела различий в группах. Частота рецидива выше в группе ТФ, по сравнению с группой ТФ (р = 0,042).
Выводы. Гибридный метод лечения является эффективной альтернативой традиционной флебэктомии.
Список литературы
1. Criqui M. H. et al. Chronic venous disease in an ethnically diverse population. - The San Diego population study // Am. J. Epidemiol. 2003. Vol. 158, № 5. P. 448–456.
2. Beebe-Dimmer J. L. et al. The epidemiology of chronic venous insufficiency and varicose veins // Ann. Epidemiol. 2005. Vol. 15, № 3. P. 175–184.
3. Robertson L., Evans C., Fowkes F. G. R. Epidemiology of chronic venous disease // Phlebology. 2008. Vol. 23, № 3. P. 103–111.
4. Fan C.-M. Epidemiology and pathophysiology of varicose veins // Tech. Vasc. Interv. Radiol. 2003. Vol. 6, № 3. P. 108–110.
5. Ebner J. A. et al. Recurrent residual or progressive varicose veins: postoperative long term follow-up of 353 patients // Ann. Ital. Chir. 2017. Vol. 88, № 6. P. 526–533.
6. Fischer R. et al. The unresolved problem of recurrent saphenofemoral reflux // J. Am. Coll. Surg. 2002. Vol. 195, № 1. P. 80–94.
7. Kostas T. et al. Recurrent varicose veins after surgery: A new appraisal of a common and complex problem in vascular surgery // Eur. J. Vasc. Endovasc. Surg. 2004. Vol. 27, № 3. P. 275–282.
8. Stonebridge P. A. et al. RECURRENT VARICOSE-VEINS - A VARICOGRAPHIC ANALYSIS LEADING TO A NEW PRACTICAL CLASSIFICATION // Br. J. Surg. 1995. Vol. 82, № 1. P. 60–62.
9. Winterborn R. J., Earnshaw J. J. Crossectomy and great saphenous vein stripping // J. Cardiovasc. Surg. (Torino). 2006. Vol. 47, № 1. P. 19–33.
10. Lynch N. P., Clarke M., Fulton G. J. Surgical management of great saphenous vein varicose veins: A meta-analysis // Vascular. 2015. Vol. 23, № 3. P. 285–296.
11. Baraldi C., Carelli M., Rinaldi F. OP-062 : HYBRID TECHNIQUES FOR TREATMENT OF VARICOSE VEINS: COMBINED NEW AND CONVENTIONAL TECHNOLOGIES // Int. J. Cardiol. Elsevier, 2011. Vol. 147. P. S56.
12. Hamdan A. Management of Varicose Veins and Venous Insufficiency // JAMA. 2012. Vol. 308, № 24. P. 2612.
13. Andrzej P., Zbigniew R. Hybrid strategy in the treatment of difficult to heal venous leg ulcers // Phlebol. Rev. Termedia, 2016. Vol. 4, № 4. P. 66–70.
14. Harlander-Locke M. et al. Endovenous ablation with concomitant phlebectomy is a safe and effective method of treatment for symptomatic patients with axial reflux and large incompetent tributaries // J. Vasc. Surg. 2013. Vol. 58, № 1. P. 166–172.
15. Yin H. et al. Prospective Randomized Study of Ultrasound-Guided Foam Sclerotherapy Combined with Great Saphenous Vein High Ligation in the Treatment of Severe Lower Extremity Varicosis // Ann. Vasc. Surg. 2017. Vol. 39. P. 256–263.
16. Nesbitt C. et al. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices // Cochrane Database Syst. Rev. 2011. № 10.
17. Adylkhanov F.T. Fursov.A.B. Nauka i zdravoohranenie // Nauk. i Zdravoohr. ISSN 2410-4280. 2017. Vol. 2. P. 128–143.
Valeology: Health - Illnes - recovery. 2019; : 43-48
THE COMPARATIVE ANALYSIS OF THE VARICOSE VEINS TREATMENT RESULTS AFTER THE CONVENTIONAL SURGERY AND HYBRID TREATMENT
Abstract
The purpose of this study was to compare the results of treatment of patients with varicose veins after conventional phlebectomy
and hybrid treatment.
Materials and methods. The material for the study was patients with varicose veins of the second and third clinical class according to CEAP (C2, Ep, As, Pr, n., C3, Ep, As, Pr, n.) All patients underwent surgical treatment. The first group included patients 132 patients treated by conventional surgery. The second group included 116 patients that were treated by hybrid method.
Results. The rate of complications in the early postoperative period did not differ in groups. The recurrence rate were higher in the conventional surgery group compared to the hybrid treatment (p = 0.042).
Conclusions. A hybrid method is an effective alternative to the conventional surgery.
References
1. Criqui M. H. et al. Chronic venous disease in an ethnically diverse population. - The San Diego population study // Am. J. Epidemiol. 2003. Vol. 158, № 5. P. 448–456.
2. Beebe-Dimmer J. L. et al. The epidemiology of chronic venous insufficiency and varicose veins // Ann. Epidemiol. 2005. Vol. 15, № 3. P. 175–184.
3. Robertson L., Evans C., Fowkes F. G. R. Epidemiology of chronic venous disease // Phlebology. 2008. Vol. 23, № 3. P. 103–111.
4. Fan C.-M. Epidemiology and pathophysiology of varicose veins // Tech. Vasc. Interv. Radiol. 2003. Vol. 6, № 3. P. 108–110.
5. Ebner J. A. et al. Recurrent residual or progressive varicose veins: postoperative long term follow-up of 353 patients // Ann. Ital. Chir. 2017. Vol. 88, № 6. P. 526–533.
6. Fischer R. et al. The unresolved problem of recurrent saphenofemoral reflux // J. Am. Coll. Surg. 2002. Vol. 195, № 1. P. 80–94.
7. Kostas T. et al. Recurrent varicose veins after surgery: A new appraisal of a common and complex problem in vascular surgery // Eur. J. Vasc. Endovasc. Surg. 2004. Vol. 27, № 3. P. 275–282.
8. Stonebridge P. A. et al. RECURRENT VARICOSE-VEINS - A VARICOGRAPHIC ANALYSIS LEADING TO A NEW PRACTICAL CLASSIFICATION // Br. J. Surg. 1995. Vol. 82, № 1. P. 60–62.
9. Winterborn R. J., Earnshaw J. J. Crossectomy and great saphenous vein stripping // J. Cardiovasc. Surg. (Torino). 2006. Vol. 47, № 1. P. 19–33.
10. Lynch N. P., Clarke M., Fulton G. J. Surgical management of great saphenous vein varicose veins: A meta-analysis // Vascular. 2015. Vol. 23, № 3. P. 285–296.
11. Baraldi C., Carelli M., Rinaldi F. OP-062 : HYBRID TECHNIQUES FOR TREATMENT OF VARICOSE VEINS: COMBINED NEW AND CONVENTIONAL TECHNOLOGIES // Int. J. Cardiol. Elsevier, 2011. Vol. 147. P. S56.
12. Hamdan A. Management of Varicose Veins and Venous Insufficiency // JAMA. 2012. Vol. 308, № 24. P. 2612.
13. Andrzej P., Zbigniew R. Hybrid strategy in the treatment of difficult to heal venous leg ulcers // Phlebol. Rev. Termedia, 2016. Vol. 4, № 4. P. 66–70.
14. Harlander-Locke M. et al. Endovenous ablation with concomitant phlebectomy is a safe and effective method of treatment for symptomatic patients with axial reflux and large incompetent tributaries // J. Vasc. Surg. 2013. Vol. 58, № 1. P. 166–172.
15. Yin H. et al. Prospective Randomized Study of Ultrasound-Guided Foam Sclerotherapy Combined with Great Saphenous Vein High Ligation in the Treatment of Severe Lower Extremity Varicosis // Ann. Vasc. Surg. 2017. Vol. 39. P. 256–263.
16. Nesbitt C. et al. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices // Cochrane Database Syst. Rev. 2011. № 10.
17. Adylkhanov F.T. Fursov.A.B. Nauka i zdravoohranenie // Nauk. i Zdravoohr. ISSN 2410-4280. 2017. Vol. 2. P. 128–143.
