1、99临床研究 2023 年 05 月第 31 卷第 05 期作者简介：李洪涛，男，副主任医师，本科。研究方向：普外科常见病、多发病的诊治。观察J.中华眼科杂志,2020,56(10):768-773.6GUMBER A,NISHANT P,SINHA S,et al.Changes in corneal curvature and visual acuity in North Indian adults after pterygium excision with modified sutureless,glueless limbal-conjunctival autograftJ.Indian
2、 J Ophthalmol,2021,69(9):2401-2405.7裴志娟,江军,李琼,等.翼状胬肉切除联合自体游离球结膜瓣移植术后戴角膜绷带镜的临床治疗效果J.临床眼科杂志,2021,29(5):443-446.8安方杰,尹春红.行翼状胬肉切除联合角膜缘干细胞移植术治疗翼状胬肉的价值研究J.重庆医学,2020,49(S02):153-155.9高敏.自体角膜缘干细胞移植术及保存羊膜移植术对翼状胬肉疗效对比研究J.泰山医学院学报,2019,40(12):955-956.10王天宇,顾一帆,杨敏,等.角膜缘干细胞移植术治疗原发性翼状胬肉J.国际眼科杂志,2020,20(9):1473-147
3、6.11LEE J S,CHOI Y S,JO Y J,et al.Pterygium surgery by double-sliding flaps procedure:comparison between primary and recurrent pterygiaJ.Indian J Ophthalmol,2021,69(9):2406-2411.12王润,赵莲,马可,等.羊膜移植术与自体角膜缘干细胞移植术治疗翼状胬肉的效果比较J.实用临床医药杂志,2021,25(12):5-8.13岳丽芝.单纯翼状胬肉切除术和自体角膜缘干细胞移植术治疗翼状胬肉疗效比较J.山西医药杂志,2018,47(
4、13):1573-1575.临床治疗高位结扎加剥脱术治疗大隐静脉曲张的临床疗效李洪涛(洛阳伊滨区李村镇卫生院 外科，河南 洛阳 471934)摘要：目的 研究高位结扎加剥脱术治疗大隐静脉曲张的临床疗效。方法 回顾性分析洛阳伊滨区李村镇卫生院2017 年 6 月至 2022 年 6 月收治的 62 例大隐静脉曲张患者治疗情况，根据治疗手术方式差异分为两组。其中对照组 31例，实施高位结扎加传统抽剥脱术治疗；研究组 31 例，实施高位结扎加剥脱术治疗。观察两组患者治疗期间及治疗后情况、创伤定量指标、手术前后生活质量调查表(CIVIQ)、并发症发生情况、复发率。结果 研究组手术时间长于对照组，下床活
5、动时间、住院时间更短，术中出血量更低。术前两组患者各项创伤定量指标 丙二醛(MDA)、超氧化物歧化酶(SOD)、一氧化氮(NO)、白细胞介素(IL-6)比较差异无统计学意义(P 0.05)；术后 72 h 研究组 MDA、NO、IL-6 水平低于对照组，SOD 水平高于对照组，差异有统计学意义(P 0.05)。两组术前各项 CIVIQ 评分比较，差异无统计学意义(P0.05)；术后7 d，两组CIVIQ评分均出现明显提高，且研究组高于对照组，差异有统计学意义(P0.05)。研究组术后并发症发生率(16.13%)低于对照组(48.39%)，且研究组复发率(3.23%)低于对照组(16.13%)，
6、差异有统计学意义(P 0.05)。结论 大隐静脉曲张患者，在实施高位结扎加剥脱术后，术中整体出血量较少，能够缩短患者下床及住院时间，降低术中创伤，提升术后生存质量，且患者并发症发生率及复发率均下降，术中及术后恢复情况较为理想，值得应用。关键词：高位结扎加剥脱术；大隐静脉曲张；疗效中图分类号：R654.4文献标志码：B DOI：10.12385/j.issn.2096-1278(2023)05-0099-04Clinical Effectiveness of High Ligation and Stripping in the Treatment of the Great Saphenous V
7、aricose VeinLI Hongtao(Department of Surgery,Licun Township Hospital,Yibin District,Luoyang,Luoyang Henan 471934,China)Abstract:Objective To study the clinical effectiveness of high ligation and stripping in treating the great saphenous varicose vein(GSVV).Methods A total of 62 GSVV patients treated
8、 from June 2017 to June 2022 in Licun Township Hospital,Yibin District,Luoyang were reviewed.According to different surgical modes,31 cases received the high ligation and traditional peeling were included in the control group,and 31 cases received the high ligation and stripping were included in the
9、 study group.The conditions of the two groups during and after treatment,quantitative trauma indicators,preoperative and postoperative quality of life questionnaire(CIVIQ),complications and recurrence rate were observed.Results The operation time of the study group was longer than that of the contro
10、l group,and the time of getting out of bed,hospitalization were shorter,and intraoperative bleeding volume was even lower.There were no differences between the two groups in the quantitative indexes of trauma malondialdehyde(MDA),superoxide dismutase(SOD),nitric oxide(NO),interleukin 6(IL-6)before o
11、peration(P0.05);The levels of MDA,NO and IL-6 in the study group were lower than those in the control group 72 hours after operation,while SOD was higher than that in the control group,with significant differences between the groups(P 0.05);There were no significant differences in CIVIQ scores betwe
12、en the two groups before operation(P 0.05).The CIVIQ scores of the two groups were significantly improved 7 days after operation,and those of the study group were higher than those of the control group,with significant differences between the groups(P 0.05);The total incidence of postoperative compl
13、ications in the study group was 16.13%,lower than that in the control group(48.39%),and the recurrence rate in the study group was 3.23%,lower than that in the control group(16.13%),the differences between groups were significant(P 0.05).Conclusion For patients with greater 100Clinical Research,May
14、2023,Vol.31 No.05saphenous varicose veins,after high ligation and stripping,the overall blood loss during the operation is less,which can shorten the time of getting out of bed and hospital stay,reduce intraoperative trauma,and improve the quality of survival after operation,and the complication rat
15、e and recurrence rate of patients are reduced,and the intraoperative and postoperative recovery is ideal,which is worth application.Key Words:high ligation and stripping;great saphenous varicose vein;effectiveness大隐静脉曲张(GSVV)主要是由于久坐或久站后，患者下肢发生的静脉曲张，属于常见外科疾病，其特征为下肢浅静脉扩张伸长，患者伴有患肢有肿胀疼痛，下肢浅静脉曲张，伴随明显的沉重感
16、等症状1。若无法及时采取治疗，会使得患者下肢皮肤发生营养不良，并形成血栓，严重甚至会伴随静脉炎与下肢深静脉血栓等并发症，足部随之发生水肿，病变部位发生色素沉着，使得患者出现疼痛、化脓、瘙痒等症状。当前主要治疗方案为手术干预，传统手术方案大多选择高位结扎剥脱术，该手术方案下切口较大，且术后恢复较慢，患者会出现较多并发症，因此在治疗上需要进行改良。临床不断在开发创伤更小的治疗方案，激光及刨吸等新型治疗方案不断出现，同时新型的治疗方案也在不断通过临床评估，有诸多学者2-3指出高位结扎加剥脱术可获得较为理想的治疗效果，治疗期间优势明显。因此本研究通过分析高位结扎加剥脱术治疗的有效性，报道如下。1资料与方法1.1一般资料回顾性分析洛阳伊滨区李村镇卫生院 2017 年 6 月至2022 年 6 月收治 62 例大隐静脉曲张患者，根据治疗手术方式差异分为两组，均 31 例。对照组女 13 例，男 18 例；年龄 40 74 岁，平均(65.954.01)岁；病程 2 4 年，平均(3.120.35)年；身体质量指数(BMI)19 26kg/m2，平均(22.651.05)kg/m2。研 究 组 女
