静脉腔内激光消融术治疗下肢慢性静脉疾病
- Author
- Daniel M Ihnat, MD
Daniel M Ihnat, MD
- Adjunct Associate Professor of Surgery
- University of Minnesota
- Section Editors
- Joseph L Mills, Sr, MD
Joseph L Mills, Sr, MD
- Section Editor — Vascular and Endovascular Surgery
- Professor and Chief
- Division of Vascular Surgery and Endovascular Therapy
- Baylor College of Medicine
- John F Eidt, MD
John F Eidt, MD
- Section Editor — Vascular and Endovascular Surgery
- Professor of Surgery, Texas A&M Health Science Center
- Vice Chair of Vascular Surgical Services, Baylor Heart and Vascular Hospital at Dallas
- Deputy Editor
- Kathryn A Collins, MD, PhD, FACS
Kathryn A Collins, MD, PhD, FACS
- Deputy Editor — General Surgery
- Translators
- 褚延魁, 主任医师
褚延魁, 主任医师
- 中国人民解放军第三〇二医院普通外科
引言
静脉腔内激光消融术(endovenous laser ablation, EVLA)是一项应用激光能量消融功能不全的浅表静脉的经皮穿刺技术。此疗法主要针对纵向的静脉,包括大隐静脉(great saphenous vein, GSV)、小隐静脉(small saphenous vein, SSV)和副隐静脉(accessory saphenous vein, ASV)。本专题将总结EVLA的指征、围手术期治疗和结局。
慢性静脉疾病的其他治疗方法,包括激光和光疗法、射频能量、液体和泡沫硬化疗法,以及开放性手术治疗,将在别处讨论。
●(参见“下肢慢性静脉疾病的概述和治疗”)
●(参见“下肢毛细血管扩张、网状静脉和小静脉曲张的激光和光疗法”)
●(参见“下肢慢性静脉疾病的射频消融术治疗”)
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2017-06-22.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Schoonover JP, King JT, Gray C, et al. 3 alternatives to standard varicose vein treatment. J Fam Pract 2009; 58:522.
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Topic Outline- 引言
- 指征
- 禁忌证
- 解剖
- 静脉解剖
- 隐神经
- 腓肠神经
- 作用机制和激光设备
- 手术前评估和准备
- 药物治疗
- 预防性抗生素疗法
- 深静脉血栓形成的预防
- 计划辅助操作
- 患者知情同意
- 压力袜
- 安排双功能超声检查
- 静脉标记
- 操作
- 准备
- - 仪器
- - 药物
- - 材料
- 基本技术要点
- - 准备和体位
- - 置入导管鞘
- - 导管放置
- - 输注肿胀麻醉剂
- - 静脉消融
- - 术后超声检查
- - 辅助治疗
- 特定的解剖学注意事项
- - 大隐静脉消融
- - 小隐静脉消融
- 穿通静脉消融
- 随访治疗
- 疼痛治疗
- 患者指导
- 术后双功能超声
- 临床医生随访
- 并发症
- 瘀斑/血肿
- 皮肤烧伤
- 浅表性血栓性静脉炎
- 深静脉血栓形成
- 神经损伤
- 技术并发症
- - 解剖学失败
- - 其他问题
- 静脉闭合率
- 大隐静脉
- 副隐静脉和小隐静脉
- 穿通静脉
- 临床结局
- 恢复正常活动
- 术后疼痛
- 静脉复发
- 成本
- 患者教育
- 总结与推荐
- REFERENCES
GRAPHICS
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