| Varicose veins in the lower limbs are the most common diseases in peripheral vascular surgery.The pathophysiological basis of varicose veins is the valvular incompetence at the intersection of the great saphenous vein and the deep veins,which induces the reverse blood flow from the deep vein toward the great saphenous vein causing the great saphenous veins to swollen and twisted.Symptoms of the varicose veins include the dilatation and stretch of the superficial veins in the lower limbs,fatigue and discomfort of the legs,swelling discomfort after walking or standing for a long time,swelling of the limbs accompanied by pain,skin nutritional changes,ulcers at the swollen and twisted great saphenous veins,and so on.In severe cases,varicose veins can even cause physical disability,seriously affecting the patients’ quality of life.Because of the unique clinical features,the physical and psychological conditions of the patients caused by varicose veins have become a public health issue with great concern.The treatments for varicose veins include traditional surgery,also known as traditional vein stripping surgery,and CHIVA surgery developed in recent years.By comparing and analyzing the therapeutic effects and adverse reactions of the two surgeries,this study provided a theoretical basis and data basis for additional options for patients for treating varicose veins.Objective: To compare the therapeutic effects and adverse reactions of CHIVA and traditional vein stripping surgery.Methods: The 23 patients with varicose veins in the lower extremities performed CHIVA surgery from September 2019 to September 2020 at the Second Hospital of Hebei Medical University were selected as the CHIVA group,and 76 patients performed traditional vein stripping surgery with no statistical difference in average age,gender composition,and CEAP classification compared with CHIVA group were selected as a control group.The patients had received lower extremities vein Doppler ultrasound and/or lower extremities deep vein anterograde angiography before surgery.The therapeutic effects and adverse reactions of the two surgeries were compared by comparing the preoperative CEAP classification,preoperative signs and symptoms of patients,postoperative telephone follow-up for surgical effects,recrudescence of the disease,complications,and postoperative relapse rate of the patients in the two groups.Results: All of the 99 patients with superficial varicose veins in the lower extremities meet the diagnostic criteria CEAP2 term or above,and Colour Doppler Ultrasound and anterograde venography for the deep vein of lower limbs showed no surgical contraindications for the patients.After fully informing the procedures and related risks of the two surgeries to the patients and their families,23 patients received CHIVA treatment,and 76 received traditional vein stripping surgery.The sex composition(17male,6 female),age(57.57±12.86 years),and hospitalization days(6.69±0.68)in CHIVA group had no statistical difference(P>0.05)with the gender(47 male,29female),age(56.95 + 10.16 years),and hospitalization days(9.43±0.85)in the vein stripping group.And the CEAP stage of the two groups had no significant difference(P > 0.05)either.The 99 patients were followed up 3 months after the operations,and the data was adjusted during the follow-up due to the loss of connection.Two patients lost to follow up in the CHIVA group,and 4patients lost to follow up in the vein stripping group.In the CHIVA group,3cases,or 13.0%,had maintained or shallow pigmentation after the surgery,while in the vein stripping group,12 cases,accounting for 15.7%,had shallow pigmentation after the surgery.There were 0 patients(0.0%)who had post-activity edema in CHIVA group,but 4 cases(5.3%)in the vein stripping group.The paresthesia of patients in both groups mainly included itching in the affected area,electric shock-like pain,numbness,nodule-like foreign body sensation,and lower limb swelling discomfort.The paresthesia of the 6patients was persisted in CHIVA group,and no case worsened.In the vein stripping group,21 patients(27.6%)had persistent paresthesia,and two cases worsened,accounting for 2.6%.The cases with extended or newly occurred ulcer were 0 in both groups.No persistent or unhealed cases in the vein stripping group.Zero cases,accounting for 0.0%,relapsed in the CHIVA group and 7 cases,accounting for 9.2% in the vein stripping group.There was0 case of nocturnal spasms in CHIVA group,but 1 severe case and 3 incidental spasms cases,accounting for 5.3%,in the vein stripping group.The difference was not statistically significant(P>0.05).Conclusion: Compared with traditional vein stripping surgery,CHIVA showed no significant statistical differences in the adverse reactions,including post-activity edema and paresthesia,variation of the pigmentation,improvements for ulcers,and the recurrence rate of the varicose veins after surgery,indicating that CHIVA surgery is safe and effective,and can be generalized and used as one of the treatments for varicose veins in the lower extremities.Hospitalization days and consumables in CHIVA are more favorable than traditional vein stripping surgery,and CHIVA is suitable for discomfort due to organ dysfunction,which can be used as a supplement to the treatment of varicose veins. |
PDF Full Text Request