背景:对于毛细血管扩张或网状静脉的患者(CEAP[临床,病因学,解剖,病理生理学]C1类),出现了侵入性较小的腔内(EV)治疗。然而,没有前瞻性研究比较压缩长袜(CSs)和EV消融治疗C1症状性回流隐静脉的疗效.本前瞻性研究比较了两种治疗方式的治疗结果。
方法:从2020年6月至2021年12月,前瞻性纳入46例毛细血管扩张症或网状静脉(<3mm;C1级)伴轴向隐返流和静脉淤血症状的患者。患者被分配到CS(n=21)或EV治疗(n=25),根据患者的喜好。并发症,临床改善量表(如,静脉临床严重程度评分[VCSS]),和生活质量,包括阿伯丁静脉曲张症状严重程度评分(AVSS)和静脉功能不全流行病学和经济学研究-生活质量/症状(VEINES-QOL/Sym),分别于治疗后1、3、6个月对两组进行评价和比较。
结果:两组均无重大并发症发生。VCSS中位数为2.0(四分位数间距[IQR],1.0-2.0),1.0(IQR,0.5-2.0),1.0(IQR0.0-1.0),CS组在基线和治疗后1、3和6个月时为0.0(IQR0.0-1.0),分别。相应的VCSS为3.0(IQR,1.0-3.0),1.0(IQR,0.0-1.0),0.0(IQR,0.0-0.0),和0.0(IQR,0.0-0.0)在EV组中。AVSS中位数为4.4(IQR,3.0-5.5),2.1(IQR,1.3-4.6),1.0(IQR,0.0-2.8),和0.0(IQR,0.0-1.8)在基线和CS组治疗后1、3和6个月,分别。相应的分数为6.2(IQR,3.8-12.3),1.6(IQR,0.6-2.8),0.0(IQR,0.0-2.6),和0.0(IQR,0.0-0.4)在EV组中。CS组在基线和治疗后1、3和6个月的平均VEINES-QOL/Sym评分分别为92.7±8.1、100.4±7.3、104.3±8.2和106.0±9.7。分别。EV组的相应得分分别为83.6±8.0、102.9±6.6、107.9±3.9和109.6±3.7。两组在VCSS中都显示出相当大的改善,AVSS,和VEIN-SYM/QOL分数,且在≤6个月期间未观察到显著的组间差异。在有严重症状的患者中(治疗前VEINES-QOL/Sym评分≤90),EV组表现出更显著的改善(VCSSP=.029,VEINES-QOL/Sym评分P=.030).
结论:CSs和EV治疗均可改善有症状的C1患者的临床和生活质量,组间无显著差异。然而,一项亚组分析显示,严重症状C1组的EV治疗有统计学显著改善.
For patients with telangiectasia or reticular veins (CEAP [clinical, etiologic, anatomic, pathophysiologic] class C1), less invasive endovenous (EV) treatments have emerged. However, no prospective studies have compared compression stockings (CSs) and EV ablation treatment for C1 symptomatic refluxing saphenous veins. The present prospective study compared the therapeutic results of the two treatment modalities.
From June 2020 to December 2021, 46 patients with telangiectasia or reticular veins (<3 mm; class C1) with axial saphenous reflux and venous congestion symptoms were prospectively enrolled. The patients were assigned to CS (n = 21) or EV treatment (n = 25), according to patient preference. Complications, clinical improvement scales (eg, the venous clinical severity score [VCSS]), and quality of life, including the Aberdeen varicose vein symptom severity score (AVSS) and venous insufficiency epidemiological and economic study - quality of life/symptoms (VEINES-QOL/Sym), were evaluated and compared between the two groups at 1, 3, and 6 months after treatment.
No major complications occurred in either group. The median VCSS was 2.0 (interquartile range [IQR], 1.0-2.0), 1.0 (IQR, 0.5-2.0), 1.0 (IQR 0.0-1.0), and 0.0 (IQR 0.0-1.0) at baseline and 1, 3, and 6 months after treatment in the CS group, respectively. The corresponding VCSSs were 3.0 (IQR, 1.0-3.0), 1.0 (IQR, 0.0-1.0), 0.0 (IQR, 0.0-0.0), and 0.0 (IQR, 0.0-0.0) in the EV group. The median AVSS was 4.4 (IQR, 3.0-5.5), 2.1 (IQR, 1.3-4.6), 1.0 (IQR, 0.0-2.8), and 0.0 (IQR, 0.0-1.8) at baseline and 1, 3, and 6 months after treatment in the CS group, respectively. The corresponding scores were 6.2 (IQR, 3.8-12.3), 1.6 (IQR, 0.6-2.8), 0.0 (IQR, 0.0-2.6), and 0.0 (IQR, 0.0-0.4) in the EV group. The mean VEINES-QOL/Sym score was 92.7 ± 8.1, 100.4 ± 7.3, 104.3 ± 8.2, and 106.0 ± 9.7 in the CS group at baseline and 1, 3, and 6 months after treatment, respectively. The corresponding scores were 83.6 ± 8.0, 102.9 ± 6.6, 107.9 ± 3.9, and 109.6 ± 3.7 in the EV group. Both groups showed considerable improvement in the VCSS, AVSS, and VEIN-SYM/QOL scores, and no significant between-group differences were observed for ≤6 months. Among the severely symptomatic patients (pretreatment VEINES-QOL/Sym score ≤90), the EV group exhibited more marked improvement (P = .029 for the VCSS and P = .030 for the VEINES-QOL/Sym score).
Both CSs and EV treatment provided clinical and quality of life improvement in symptomatic C1 patients with refluxing saphenous veins, with no significant between-group differences. However, a subgroup analysis revealed that EV treatment provided statistically significant improvement in the severe symptomatic C1 group.