导管引导下泡沫硬化剂疗法治疗大隐静脉曲张刘小平郭伟贾鑫杜昕熊江尹太张宏鹏刘蒙[摘要]目的探讨导管引导下的泡沫硬化剂疗法治疗下肢静脉曲张的临床效果。方法选择2008年4月至8月间有微创治疗医院的30例（条）中重度下肢静脉曲张患者。其中男性11例，女性19例；年龄34-85岁，平均年龄52岁。病史2-30年，平均20年。对其进行导管引导下患肢大隐静脉主干内注射1%聚桂醇泡沫硬化剂，观察大隐静脉主干的闭合情况。结果30条患肢均在导管引导下成功注射硬化剂，平均每条患肢应用6.2ml泡沫硬化剂，27条（90%）大隐静脉主干治疗后即刻可见反流消失。术后早期大隐静脉走行轻微浅静脉炎5例（条），2周内自行缓解，无严重的并发症发生。平均随访3个月，27例患者下肢活动后酸胀、乏力感消失，下肢明显的曲张畸形静脉消失；27条患肢（90%）于治疗后2周、3个月后复诊血管超声时大隐静脉主干闭塞。4例（条）患者（15%）仅有小腿局限的轻度曲张。结论导管引导的泡沫硬化剂疗法治疗下肢静脉曲张的大隐静脉主干闭合率较高，是微创治疗下肢静脉曲张有效的新方法。[关键词]静脉曲张；硬化疗法；导管插入术，外周Catheter—directedfoamsclerotherapyofincompetentsaphenousreflux：earlyresultsLiuXiao-ping，GuoWei，JiaXin．DuXin．XiongJiang，YinTai,ZhangHong-peng，LiuMeng．DepartmentofVascularSurgery．GeneralHospitalofPeople’sLiberationArmy，Beijing100853，ChinaCorrespondingauthor：LiuXiao一ping，Email:lxpls@263．net【Abstract】ObjectiveTodescribeobservationofavailabilityofcatheter-directedfoamsclero--therapyforthegreatsaphenousveinvaricosis．MethodsAselectiveseriesof30patientsofveinvaricosisweretreatedwithfoamscleretherapyusingastandardtechniqueforfoamdeliveryfromApril2008toAugust2008．Patientsweretreatedwith1％polidocanolfoamthroughacatheter,whichwasinsertedpereutaneeuslyoveraguidewireinthegreatsaphenousvein(GSV)．allsucce--ssfullytreatedpatientswereexaminedbycolourduplextwoweeksaftertheprocedure．ResultsThirtypatientswithaninsuitlciencyrefluxoftheGSVweretreatedwidlthecatheter-directedfoa--msclerotherapy．Primarytechnicalsuccesswasachievedinallthepatien--ts．Theconcentrations(1.0％)anddoses(6to8m1)ofpolidocanolwasmainlyweused．Fivepatientsexperiencedtra--nsientscotomasanddevelopedsegmentalphlebitisofacollateralvein．Theinterventionwaswelltoleratedinallpatientswithouttheoccurrenceofserioussideeffects．In27ofthe30treatedpati--ents(90％)，aclosureoftheGSVwasfoundatcontrolvisits2weeks，3monthsaftertreatmen--t.ConclusionTheuseofanendovascularcatheterinsertedpercutaneouslyoveraguidewireisfeasibleinmostpatientsandhasresultedinhighprimaryocclusionrates．【Keywords】Varicoseveins；Scleretherapy；Catheterization，peripheral近年来，泡沫硬化剂注射治疗大隐