探讨DSA引导下选用聚多卡醇和鱼肝油酸钠两种泡沫硬化剂治疗下肢静脉曲张的疗效差异。

回顾性分析我科2018年1月至2018年12月收治的73例下肢静脉曲张患者的病历，按用药不同分为两组（A组36例、B组37例），分别选用聚多卡醇（A组）和鱼肝油酸钠（B组）在DSA引导下行泡沫硬化治疗，对临床成功率、生活质量改善情况、并发症以及住院期费用等方面进行比较。

两组患者在年龄、病程时间、术前临床病情分级、VCSS评分及CIVIQ评分差异均无统计学意义（P > 0.05）。两组治疗后随访1年内临床病情分级均有所改善，术后1年随访中，A组治疗成功者为82.9%，部分成功者为8.6%；B组治疗成功率为60.0%，部分成功者为25.7%，两组的临床成功率差异有统计学意义（χ² = 7.583，P < 0.05）。治疗后随访1年内，两组患者3项疗效评价量表均较术前有所改善，其中在术后1周、1月及1年的CEAP分级评价，术后1周的VCSS分级评价以及术后1周、1月的CIVIQ评分中，A组改善情况优于B组；两组术后不良反应主要为疼痛和色素沉着，B组发生率较A组更高；B组患者平均住院费用低于A组，组间差异有统计学意义（P < 0.01）。

鱼肝油酸钠组平均住院费用虽低于聚多卡醇组，但1年随访期中聚多卡醇治疗成功率较鱼肝油酸钠高，主观感受改善更明显，不良反应少，故聚多卡醇较鱼肝油酸钠泡沫硬化治疗下肢静脉曲张疗效好，在临床值得推广使用。

To explore the difference in curative effect of two foam sclerosing agents, polidocanol and sodium morrhuate, in the treatment of varicose veins under DSA guidance.

A retrospective analysis of the medical records of 73 patients with varicose veins of the lower extremities admitted to the Department of Minimally Invasive Intervention, Guangzhou Panyu Central Hospital from January 2018 to December 2018. They were divided into two groups according to different treatment methods (36 cases in group A, 37 cases in group B), and polidocanol (group A) and sodium morrhuate (group B) were used for DSA guided foam sclerotherapy. The contrast of different sclerosing agents were compared in terms of clinical success rate, quality of life improvement, complications, and surgical costs.

There were no significant differences between the two groups of patients in age, course of disease, preoperative clinical disease classification, VCSS scores and CIVIQ scores (P > 0.05). The clinical disease classification of the two groups improved within 1 year after treatment, and during the annual follow-up, the treatment success rate of group A was 82.9%, and the partial success rate was 8.6%, while the treatment success rate of group Bwas 60.0%, and the partial success rate was 25.7%. There was a statistically significant difference in the clinical success rate between the two groups (χ² = 7.583, P < 0.05). Within 1 year of follow-up after treatment, the three efficacy evaluation scales of the two groups of patients were improved compared with those of preoperative. Among them, the improvement of group A was better than that of group B in the CEAP grading evaluation at 1 week, 1 month and 1 year after the operation, the VCSS grading evaluation at 1 week after the operation, and the CIVIQ scores in the next week and one month after the operation. The postoperative adverse reactions of the two groups were mainly pain and pigmentation, and the incidence of group B was higher than that of group A. The average hospitalization cost of group B patients was lower than that of group A. There were statistical differences between the two groups (P < 0.01).

The average hospitalization cost of sodium morrhuate group was lower than that of polidocanol group, but during the 1-year follow-up period, the success rate of polidocanol treatment is higher than that of sodium morrhuate, including subjective feelings are improved more obviously, and adverse reactions are less. Therefore, polidocanol is more effective than sodium morrhuate in the treatment of varicose veins, and it is worthy of clinical application.