《血管与腔内血管外科杂志》2022年2月 第8卷 第2期Journal of Vascular and Endovascular Surgery Vol.8, No.2, Feb 2022射频消融术和微波消融术联合泡沫硬化剂注射治疗下肢静脉曲张短期临床效果对比高 晔1，曾 伟2，王奇奇2，林 瑶2 ，何春水21 成都中医药大学临床医学院，四川 成都 6100752 成都中医药大学附属医院血管外科，四川 成都 610075摘要：目的 对比射频消融术（RFA ）和微波消融术（EMA ）分别联合泡沫硬化剂注射治疗下肢静脉曲张的短期临床效果。
方法 收集2020年8月至2021年4月成都中医药大学附属医院收治的168例（215条患肢）行下肢静脉曲张手术患者的临床资料，根据手术方式不同将患者分为RFA 组[（n ＝83，101条患肢），采用RFA 联合泡沫硬化剂治疗）]和EMA 组[（n ＝85，114条患肢），采用EMA 联合泡沫硬化剂治疗]。
于术后2 d 、术后3个月进行随访，主要终点为作用段静脉闭塞率，次要终点包括术后3个月的静脉临床严重程度评分（VCSS ）、慢性静脉疾病生活质量问卷14问（CIVIQ-14）评分和阿伯丁静脉曲张问卷（A VVQ ）评分。
结果 两组患者术后2 d 和术后3个月的作用段静脉闭塞率比较，差异均无统计学意义（P ＞0.05）。
随访期间，两组患者均未发生深静脉血栓形成、切口感染、肺栓塞等严重不良反应。
两组患者的不良反应发生率比较，差异无统计学意义（P ＞0.05）。
术后3个月，两组患者的CIVIQ-14、A VVQ 评分比较，差异均无统计学意义（P ＞0.05）；EMA 组患者的VCSS 低于RFA 组患者，差异有统计学意义（P ＝0.016）。
结论 RFA 和EMA 分别联合泡沫硬化剂注射治疗对提高下肢静脉曲张患者的生存质量均具有良好的效果，具有临床推荐意义。
关键词：下肢静脉曲张；射频消融术；微波消融术；临床效果；泡沫硬化剂中图分类号：R543 文献标识码：A doi: 10.19418/ki.issn2096-0646.2022.02.06Comparison of short-term clinical effects of radiofrequency ablation and endovenous microwave ablation combined with foam sclerosing agent in the treatment of lower extremity varicose veinGao Y e 1, Zeng Wei 2, Wang Qiqi 2, Lin Y ao 2, He Chunshui 21 School of Clinical Medicine of Chengdu University of TCM, Chengdu 610075, Sichuan, China2 Department of Vascular Surgery, Hospital of Chengdu University of TCM, Chengdu 610075, Sichuan, China[作者简介] 高晔，主要从事血管外科中西医结合临床方向的研究，成都中医药大学临床医学院[通信作者]何春水（He Chunshui ，corresponding author ），主任医师，E-mail ：******************Abstract: Objective To compare the short-term clinical effect of radiofrequency ablation (RFA) and endovenousmicrowave ablation (EMA) combined with foam sclerosing agent in the treatment of lower extremity varicose vein. Method The clinical data of 168 patients (215 affected extremities) who underwent lower extremity varicose vein surgery who were admitted to the Hospital of Chengdu University of TCM from August 2020 to April 2021 were collected, and the patients were divided into the RFA groups [83 patients (101 affected extremities) were treated with RFA vein combined with foam sclerosing agent) and EMA group [85 patients (114 affected extremities) were treated with EMA vein combined with foam sclerosing agent] according to different surgical methods. Follow-•论著•155 Journal of Vascular and Endovascular Surgery Vol.8, No.2, Feb 2022up was performed at 2 days and 3 months after the operation. The primary endpoint was the active vein occlusion rate, and the secondary endpoints included venous clinical severity score (VCSS), chronic venous insufficiency questionnaire-14 item (CIVIQ-14), and the Aberdeen varicose vein questionnaire (AVVQ) at 3 months after the operation. Result There was no significant difference in the active vein occlusion rate between the two groups at2 days and3 months after the operation (P＞0.05). During the follow-up, no serious adverse events such as deepvein thrombosis wound infection, and pulmonary embolism was reported in both groups. There was no significant difference in the incidence of adverse events between the two groups (P＞0.05). At 3 months after the operation, there was no significant difference in CIVIQ-14 and A VVQ scores between the two groups (P＞0.05). The VCSS score of the microwave ablation group was lower than that of the radiofrequency ablation group, and the difference was statistically significant (P＝0.016). Conclusion When combined with foam sclerosing agent, either RFA or EMA could achieve good effects on improving the quality of life of patients with lower extremity varicose veins. The therapies are clinically recommended.Key words: lower extremity varicose vein; radiofrequency ablation; endovenous microwave ablation; effect; foam sclerosing agent下肢静脉曲张是指由于下肢浅静脉瓣膜功能不全引起静脉血回流障碍、静脉压力过高，从而导致以扩张性病变为主要特征的血管性疾病，以医务工作者、教师、重体力劳动者、多次妊娠女性及中老年群体多发。
