| Objective:Follow-up of the treatment effect of C5-C6 patients in the CEAP classification of chronic venous diseases of the lower extremities by foam sclerosing agent,and studied the therapeutic effect and safety of saphenous vein high ligation and decortication combined with ultrasound-guided foam sclerosing Injection solution on venous ulcers of lower extremities,and looked for safer and more effective methods for treating venous ulcers of lower extremities.Method:The clinical information of 100 patients with varicose veins(101 limbs)admitted to the Department of Vascular Surgery of China-Japan Union Hospital of Jilin University from January 2019 to March 2022 were collected,and 100 patients were randomly divided into the observation group and the control group.The observation group had 51 cases.The patient underwent high saphenous vein ligation and stripping combined with ultrasound-guided foam sclerotherapy,postoperative dressing change + compression therapy;49 patients in the control group underwent high saphenous vein ligation and stripping,postoperative Dressing change +compression therapy,and a 6-month follow-up after surgery.The age,sex,BMI,medical history,affected limb,past history,family history,CEAP grade,Kistner grade,VCSS score data and other data of the two groups were recorded,and statistical methods were used to compare.Results:All 100 patients enrolled in this study successfully completed simple open surgery or combined surgery and completed 6-month follow-up.There was no significant difference in age,gender,BMI,affected lower limb,medical history,past history,family history,CEAP grading,Kistner grading,and VCSS score between the two groups before surgery(P>0.05).At 3 months after operation,the total VCSS score of the observation group decreased from 17.08±3.76 before operation to7.14±1.69,and the total VCSS score of the control group decreased from 17.41±4.44 before operation to 10.51±2.92,and there was a statistically significant difference in the VCSS total score 3 months after surgery(P<0.05).Judging from the degree of decline in the total score,the effect of the observation group was better than that of the control group.Except for pain,inflammation and compression therapy,the main complaints and signs of the observation group were better than those of the control group at 3 months after operation,and the difference between the two groups was statistically significant(P<0.05).Six months after operation,the total VCSS score of the observation group decreased from 7.14±1.69 before operation to 4.84±0.93,and the total VCSS score of the control group decreased from 10.51±2.92 to 6.80±1.91 before operation.The difference in total score was statistically significant(P<0.05).The indexes except pain and venous edema showed that the chief complaints and signs of the observation group were better than those of the control group at 6months after operation,and the difference between the two groups was statistically significant(P<0.05).Kaplan-Meier survival analysis showed that the ulcers in the two groups at 6months after the operation showed a downward trend in the proportion of no ulcers in the two groups.The decrease in the observation group was greater than that in the control group.The average healing time of the observation group was 2.4±0.14 months,and the average healing time of the control group was 4.98±0.43 months,and the healing time was significantly shortened after the application of hardener.After treatment,there was no one case of complications in DVT/PE,transient cerebral ischemia,fat liquefaction and lymphatic fistula in the two groups.Conclusion:Compared with the ligation and stripping of the great saphenous vein alone,the combined application of foam sclerosing agent has a significantly better surgical effect,and can cure the patients with venous lower extremity ulcers in CEAP grades C5-C6 in the short and medium term. |
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