关键词: 静脉腔内激光闭合术, 内镜深筋膜下穿通静脉离断术, 下肢静脉曲张, 病理性穿通静脉功能不全, 疼痛程度, 应激反应

Abstract:

Objective To observe the clinical effi cacy of endovenous laser ablation (EVLA) and endoscopic submucosal perforator surgery (SEPS) in the treatment of lower limb varicose veins with pathological perforating venous insuffi ciency. Method 83 patients with lower limb varicose veins accompanied by pathological perforating venous insuffi ciency treated in Dunhua City Hospital from April 2021 to March 2024 were selected and divided into EVLA group (n=42) and SEPS group (n=41) according to diff erent treatment methods. Compare the surgical related indicators, pain level, stress response, and quality of life between two groups of patients. Result The surgical time, incision length, hospitalization time, and postoperative bed rest time of patients in the EVLA group were shorter than those in the SEPS group, and the intraoperative blood loss was less than that in the SEPS group, with significant differences (P ＜ 0.05). There was no significant difference in the incidence of postoperative complications between the two groups of patients (P ＞ 0.05). At 3, 12, 24, and 48 hours postoperatively, the NRS scores of patients in the EVLA group were signifi cantly lower than those in the SEPS group (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in cortisol and adrenaline levels between the two groups of patients (P ＞ 0.05). Two days after surgery, the levels of cortisol and adrenaline in both groups of patients increased compared to preoperative levels, and the cortisol and adrenaline levels in the EVLA group were lower than those in the SEPS group, with signifi cant diff erences (P ＜ 0.05). Before surgery, there was no signifi cant diff erence in CIVIQ scores between the two groups of patients (P ＞ 0.05). Three months after surgery, the CIVIQ scores of both groups of patients increased compared to preoperative levels. The CIVIQ score of the EVLA group was higher than that of the SEPS group, and the diff erence was signifi cant (P ＜ 0.05). Conclusion For patients with lower limb varicose veins accompanied by pathological perforating dysfunction, EVLA and SEPS have similar eff ects in reducing the incidence of complications. However, EVLA can shorten the recovery time of patients, reduce stress reactions and body pain, and improve their quality of life.

Key words: Endovenous laser ablation, Subfascial endoscopic perforator surgery, Varicose veins in the lower limbs, Pathological perforating venous insuffi ciency, Pain level, Stress response