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目的探讨肥胖与非肥胖患者行大隐静脉剥脱术后中期效果的差异。方法选择2012年7月至2013年12月,在承德医学院附属医院因下肢浅静脉曲张并接受大隐静脉剥脱术的患者为研究对象。随机抽取30例肥胖患者(体质量指数≥28 kg/m~2)为肥胖组,以年龄、性别、静脉临床症状严重程度评分(VCSS)及股静脉反流情况为参照,以1∶1匹配非肥胖患者作为非肥胖组。比较两组患者中期随访结果。结果两组患者平均随访13.1个月。肥胖组患者持续穿戴弹力袜的时间短于非肥胖组(P<0.05)。随访中,所有患者VCSS及Aberdeen静脉曲线问卷(AVVQ)评分均较术前有明显改善,但肥胖组AVVQ评分高于非肥胖组(P<0.05);而VCSS评分,两组间比较,差异无统计学意义(P>0.05)。术后股静脉反流的改变情况,两组间比较,差异也无统计学意义(P>0.05)。结论下肢静脉曲张合并肥胖患者行大隐静脉剥脱术后至中期阶段,相应体征及生活质量均能得到明显改善,但患者主观症状的改善程度劣于非肥胖患者,这可能与前者术后穿戴弹力袜的时间相对较短有关。而在股静脉反流的改变方面,肥胖可能并非重要影响因素。
Objective To investigate the difference of mid-term effect of saphenous vein ablation in obese and non-obese patients. Methods From July 2012 to December 2013, patients undergoing superficial varicose veins and receiving saphenous vein ablation in the Affiliated Hospital of Chengde Medical College were selected as the study subjects. Thirty patients with obesity (body mass index ≥28 kg / m ~ 2) were randomly selected from the obese group. The data were analyzed by age, sex, clinical severity of venous disease (VCSS) and femoral vein regurgitation Non-obese patients as non-obese group. The results of interim follow-up were compared between the two groups. Results The two groups were followed up for an average of 13.1 months. Obese patients continued to wear elastic stockings shorter than non-obese group (P <0.05). At follow-up, the AVSS scores of VCSS and Aberdeen were all significantly improved in all patients, but the AVVQ scores of obese patients were significantly higher than those of non-obese patients (P <0.05) Statistical significance (P> 0.05). Postoperative femoral vein reflux changes, the two groups, the difference was not statistically significant (P> 0.05). Conclusions The signs and quality of life of patients with varicose veins complicated with obesity after saphenous vein exfoliation can be significantly improved after the operation, but the degree of subjective symptom improvement is worse than that of non-obese patients, which may be related to the former wear elastic Socks time is relatively short. In the femoral vein regurgitation changes, obesity may not be an important factor.