泡沫硬化治疗下肢静脉曲张研究进展

doi:10.3877/cma.j.issn.2095-5782.2017.02.002

20世纪60年代，泡沫硬化疗法开始应用于下肢静脉曲张的治疗，经过50多年的发展，下肢静脉曲张泡沫硬化技术日趋成熟，其在各种类型下肢静脉曲张不同时期治疗中的安全性和有效性得到广大医生和患者的认可，世界各地纷纷推出各自的指南，该法成为下肢静脉曲张的标准手术方式之一。然而，目前关于泡沫硬化疗法的使用范围和复发率仍存在争议，各医疗机构使用泡沫硬化技术存在差异，得到的统计数据参差不齐，在国内开展的多中心、大样本的循证医学证据尚不足。

关键词: 泡沫硬化疗法, 下肢静脉曲张

In the early 1960’s, sclerotherapy began to be applied in treatment of lower extremity varicose vein. With its development for the past over 50 years, sclerotherapy has become a mature technique in treating various types and phases of lower extremity varicose vein, with its efficacy and security being widely recognized in medical field. In many countries around the world, they put forward the guidelines of sclerotherapy, which point out that sclerotherapy is one of the standard strategies in treating lower extremity varicose vein. However, sclerotherapy is still in dispute in the field due to the limitation of the application range and possible recurrence. There are existing lots of differences on statistical data among different institutions on account of technological disparity, and less evidence in multi-center sizable study in China.

Key words: Foam sclerotherapy, Varicose veins of the lower extremities

1	罗军，刘文德，艾则孜•阿不都热依木, 等. 经微小切口手术治疗大隐静脉曲张[J]. 新疆医科大学学报, 2004, 27(3): 258-259.
2	叶志东，刘鹏，阎正明, 等. 腔内射频消融静脉闭合联合透光直视旋切术微创治疗下肢静脉曲张 [J]. 中日友好医院学报, 2004, 18(4): 204-206.
3	李学锋，董宗俊，张建, 等. 大隐静脉曲张微创外科治疗 [J]. 临床外科杂志, 2004, (s1): 19-20.
4	叶志东，陈洁，樊雪强, 等. 下肢静脉曲张的治疗现状 [J]. 中国血管外科杂志电子版, 2012, 4(1): 6-7.
5	Committee GO, Force T. Guidelines of care for sclerotherapy treatment of varicose and telangiectatic leg veins. American Academy of Dermatology [J]. J Am Acad Dermatol, 1996, 34(3): 523-528.
6	Wollmann JC. The history of sclerosing foams [J]. Dermatol Surg, 2004, 30(5): 694-703.
7	王永光. 聚桂醇:新型的微创硬化治疗技术[J]. 微创医学, 2011, 6(1): 1-3. doi:10.3969/j.issn.1673-6575.2011.01.002.
8	Cabrera J, Cabrera J Jr, Garcia-Olmedo MA, et al. Treatment of venous malformations with sclerosant in microfoam form [J]. Arch Dermatol, 2003, 139(11): 1409-1416.
9	Breu FX, Guggenbichler S. European Consensus Meeting on Foam Sclerotherapy, April, 4-6, 2003, Tegernsee, Germany[J]. Dermatol Surg, 2004, 30(5): 709-717.
10	Breu FX, Guggenbichler S, Wollmann JC，et al. Duplex ultrasound and efficacy criteria in foam sclerotherapy from the 2nd European Consensus Meeting on Foam Sclerotherapy 2006, Tegernsee, Germany[J]. Vasa, 2008, 71(1): 90-95.
11	Bergan J, Pascarella L, Mekenas L. Venous disorders: treatment with sclerosant foam [J]. Journal of Cardiovascular Surgery, 2006, 47(1):9-18.
12	Gibson KD, Ferris BL, Pepper D. Foam sclerotherapy for the treatment of superficial venous insufficiency.[J]. Surg Clin North Am, 2007, 87(5):1285-1295, xii-xiii.
13	O'Hare JL, Earnshaw JJ. The use of foam sclerotherapy for varicose veins: a survey of the members of the Vascular Society of Great Britain and Ireland[J]. Eur J Vasc Endovasc Surg, 2007, 34(2):232-235.
14	顾建平. 加强下肢静脉病变的影像诊断和介入治疗研究 [J]. 介入放射学杂志, 2008, 17(1): 1-3.
15	崔世军，张建，谷涌泉, 等. 硬化剂治疗下肢小静脉曲张72例临床研究 [J]. 中国普通外科杂志, 2010, 19(6): 707-711.
16	李龙，李彦豪，曾欣巧, 等. X线透视引导下下肢静脉曲张泡沫硬化治疗的技术方法和疗效观察 [J]. 中华放射学杂志, 2010, 44(11): 1180-1184.
17	Rasmussen L, Lawaetz M, Bjoern L, et al. Randomized clinical trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years[J]. J Vasc Surg, 2013, 58(2):421-426.
18	Kalodiki E, Lattimer CR, Azzam M, et al. Long-term results of a randomized controlled trial on ultrasound-guided foam sclerotherapy combined with saphenofemoral ligation vs standard surgery for varicose veins[J]. J Vasc Surg, 2011, 55(2):451-457.
19	Bullens-Goessens YIJM, Mentink LF, Nelemans PJ, et al. Ultrasound-guided sclerotherapy of the insufficient short saphenous vein: Functional improvement measured by air plethysmography[J]. Phlebology, 2004, 33(3):89-91.
20	Hamel-Desnos C, Ouvry P, Benigni JP, et al. Comparison of 1% and 3% polidocanol foam in ultrasound guided sclerotherapy of the great saphenous vein: a randomised, double-blind trial with 2 year-follow-up. "The 3/1 Study"[J]. Eur J Vasc Endovasc Surg, 2008, 34(6):723-729.
21	Rabe E, Otto J, Schliephake D, et al. Efficacy and safety of great saphenous vein sclerotherapy using standardised polidocanol foam (ESAF): A randomised controlled multicentre clinical trial[J]. Eur J Vasc Endovasc Surg, 2008, 35(2):238-245.
22	Jia X, Mowatt G, Burr JM, et al. Systematic review of foam sclerotherapy for varicose veins[J]. Br J Surg, 2007, 94(8):925-936.
23	Figueiredo M, Araújo S, BN Jr, et al. Results of surgical treatment compared with ultrasound-guided foam sclerotherapy in patients with varicose veins: a prospective randomised study[J]. Eur J Vasc Endovasc Surg, 2009, 38(6):758-763. doi: 10.1016/j.ejvs.2009.07.015.
24	Bos RVD, Arends L, Kockaert M, et al. Endovenous therapies of lower extremity varicosities: A meta-analysis[J]. J Vasc Surg, 2009, 49(1):230-239. doi: 10.1016/j.jvs.2008.06.030.
25	Shadid N, Ceulen R, Nelemans P, et al. Randomized clinical trial of ultrasound-guided foam sclerotherapy versus surgery for the incompetent great saphenous vein[J]. Br J Surg, 2012, 99(8):1062-1070. doi: 10.1002/bjs.8781.
26	Lattimera CR, Kalodiki E, Shawish E, et al. Cost and effectiveness of laser with phlebectomies compared with foam sclerotherapy in superficial venous insufficiency. Early results of a randomised controlled trial [J]. Eur J Vasc Endovasc Surg, 2012, 43(5): 594-600. doi: 10.1016/j.ejvs.2012.01.032.
27	Grover G, Tanase A, Elstone A, et al. Chronic venous leg ulcers: Effects of foam sclerotherapy on healing and recurrence [J]. Phlebology, 2014, 31(1):34-41. doi: 10.1177/0268355514557854.
28	Baeshko A, Shestak N, Korytko S. Results of Ultrasound-guided foam sclerotherapy of the great saphenous vein with new parameters of the technique[J]. Vasc Endovascular Surg, 2016, 50(8):528-533. doi: 10.1177/1538574416675482.
29	Kishore R, Sankar TB, Anandi A, et al. A prospective study in comparison of ambulatory phlebectomy and duplex guided foam sclerotherapy in the management of varicosities with isolated perforator incompetence[J]. Indian J Surg, 2016，78(5):356-363.
30	Rabe E, Breu F, Cavezzi A, et al. European guidelines for sclerotherapy in chronic venous disorders[J]. Phlebology, 2013:338-354.
31	Cavezzi A, Frullini A, Ricci S, et al. Treatment of varicose veins by foam sclerotherapy: Two clinical series[J]. Phlebology, 2002, 17(1):13-18.
32	Ceulen RP, Bullens-Goessens YI, et al. Outcomes and side effects of duplex-guided sclerotherapy in the treatment of great saphenous veins with 1% versus 3% polidocanol foam: results of a randomized controlled trial with 1-year follow-up [J]. Dermatol Surg, 2007, 33(3): 276-281.
33	Hamel-Desnos C, Ouvry P, Benigni JP, et al. Comparison of 1% and 3% polidocanol foam in ultrasound guided sclerotherapy of the great saphenous vein: a randomised, double-blind trial with 2 year-follow-up. "The 3/1 Study" [J]. Eur J Vasc Endovasc Surg, 2007, 34(6): 723-729.
34	Blaise S, Bossonb JL. Ultrasound-guided sclerotherapy of the great saphenous vein with 1% vs. 3% polidocanol foam: a multicentre double-blind randomised trial with 3-year follow-up[J]. Eur J Vasc Endovasc Surg, 2010, 39(6):779-86. doi: 10.1016/j.ejvs.2010.01.022.
35	Guex JJ. Foam sclerotherapy: An overview of use for primary venous insufficiency[J]. Semin Vasc Surg, 2005, 18(1):25-29.
36	Lawaetz M, Serup J, Lawaetz B, et al. Comparison of endovenous radiofrequency ablation, laser ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Extended 5-Year Follow-up of a RCT [J]. Int Angiol, 2017, 53(3): 281-288. doi: 10.23736/S0392-9590.17.03827-5.
37	Smith PC. Chronic venous disease treated by ultrasound guided foam sclerotherapy [J]. Eur J Vasc Endovasc Surg, 2006, 32(5): 577-83.
38	Darvall KA, Bate GR, Bradbury AW. Patient-reported outcomes 5-8 years after ultrasound-guided foam sclerotherapy for varicose veins [J]. Br J Surg, 2014, 101(9): 1098-1104. doi: 10.1002/bjs.9581.
39	Belcaro G, Dugall M, Corsi M. Superficial venous incompetence: Low-cost outpatient mini-surgery, sclerotherapy and combined procedure as a management plan. Costs and efficacy. A 20-year, follow-up registry [J]. Minerva Chirurgica, 2015, 13(1): 109-113.
40	Davies HO, Popplewell M, Darvall K, et al. A review of randomised controlled trials comparing ultrasound-guided foam sclerotherapy with endothermal ablation for the treatment of great saphenous varicose veins [J]. Phlebology, 2015, 31(4): 1031-1034.
41	Guex JJ. Complications and side-effects of foam sclerotherapy [J]. Phlebology, 2009, 24(6): 270-274.
42	Kotb MM, Shakiban HK, Sawaby AF. Foam treatment for varicose veins; efficacy and safety [J]. Alexandria Journal of Medicine, 2013, 49(49): 249-253.
43	Gillet JL, Guedes JM, Guex JJ, et al. Side-effects and complications of foam sclerotherapy of the great and small saphenous veins: A controlled multicentre prospective study including 1025 patients [J]. Phlebology, 2009, 24(3): 131-8. doi: 10.1258/phleb.2008.008063.
44	Wright D, Gobin JP, Bradbury AW, et al. Varisolve® polidocanol microfoam compared with surgery or sclerotherapy in the management of varicose veins in the presence of trunk vein incompetence: European randomized controlled trial [J]. Phlebology, 2006, 21(21): 180-90.
45	Yin H, He H, Wang M, et al. Prospective randomized study of ultrasound-guided foam sclerotherapy combined with GSV high ligation in the treatment of severe lower extremity varicosis [J]. Ann Vasc Surg, 2017, 39:256-263. doi: 10.1016/j.avsg.2016.06.027.
46	Venermo M, Saarinen J, Eskelinen E, et al. Randomized clinical trial comparing surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy for the treatment of great saphenous varicose veins [J]. Br J Surg, 2016, 103(11): 1438-44. doi: 10.1002/bjs.10260.

[1]	刘玉江, 钱林学, 刘冬, 赵军凤. 超声引导双极射频感应温热疗法治疗下肢静脉曲张[J/OL]. 中华医学超声杂志（电子版）, 2018, 15(10): 747-750.
[2]	中国医师协会血管外科医师分会静脉学组. 常见静脉疾病诊治规范（2022年版）[J/OL]. 中华普通外科学文献(电子版), 2022, 16(04): 255-272.
[3]	李美清, 王晓丹, 李英, 吴剑菲. 下肢静脉曲张微创刨吸术的手术配合[J/OL]. 中华普通外科学文献(电子版), 2011, 05(06): 537-538.
[4]	张楠, 马妍, 贾建婷, 谢慧, 张连城. 针灸治疗下肢静脉曲张的研究进展[J/OL]. 中华针灸电子杂志, 2021, 10(04): 153-156.
[5]	张勇创, 李威, 满文玲, 杨坡. 超声引导下微波消融治疗下肢静脉曲张的疗效观察[J/OL]. 中华介入放射学电子杂志, 2023, 11(03): 218-222.
[6]	贺嘉男, 张永裕, 王大帅, 赵逆, 黄伟乐, 郭辉. 经皮穿通静脉闭合术治疗下肢静脉曲张合并穿通静脉功能不全36例分析[J/OL]. 中华介入放射学电子杂志, 2021, 09(04): 360-364.
[7]	冯惠岗, 张健谊, 梁奇伟, 陈汉威, 唐郁宽, 黄益. 聚多卡醇与鱼肝油酸钠泡沫硬化治疗下肢静脉曲张的疗效差异[J/OL]. 中华介入放射学电子杂志, 2021, 09(03): 270-274.
[8]	李伟, 李威, 满文玲, 杨坡. 射频消融术在下肢静脉曲张中的运用价值[J/OL]. 中华介入放射学电子杂志, 2021, 09(01): 85-91.
[9]	梁奇伟, 冯惠岗, 庄炜钊, 郭惠庄, 黄晨, 陈广源, 唐郁宽, 陈汉威, 黄益. 透视下聚多卡醇硬化治疗C₅~C₆期下肢静脉性溃疡的疗效[J/OL]. 中华介入放射学电子杂志, 2016, 04(04): 216-220.
[10]	郭惠庄, 余盛龙, 冯惠岗, 庄炜钊, 黄晨, 唐郁宽, 吴鹏, 谢贞静, 陈汉威. DSA引导下泡沫硬化术与大隐静脉高位结扎联合血管腔内激光术治疗下肢静脉曲张的疗效观察[J/OL]. 中华介入放射学电子杂志, 2015, 03(02): 69-73.
[11]	钱结胜, 周斌, 王皓帆, 姜在波, 朱康顺, 关守海, 黄明声, 李征然, 单鸿. 腔内激光消融联合泡沫硬化治疗下肢静脉曲张[J/OL]. 中华介入放射学电子杂志, 2013, 01(02): 26-28.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Research progress on sclerotherapy in treatment of lower extremity varicose vein

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Research progress on sclerotherapy in treatment of lower extremity varicose vein