cmedasНепрерывное медицинское образование и наукаContinuing Medical Education and Science2949-62923033-585XAGUcmedas-23Research ArticleСЕРДЕЧНО-СОСУДИСТАЯ ХИРУРГИЯCARDIOVASCULAR SURGERYКОМПЛЕКСНЫЙ ПОДХОД К ИЗОЛИРОВАННОЙ ЛИКВИДАЦИИ РЕФЛЮКСА ПО МАГИСТРАЛЬНЫМ ПОВЕРХНОСТНЫМ ВЕНАМCOMPREHENSIVE APPROACH TO ISOLATED ELIMINATION OF SUPERFICIAL TRUNCAL REFLUXФокинА. А.FokinA. A.

Фокин Алексей Анатольевич, доктор медицинских  наук, профессор, заведующий кафедрой Хирургии  института дополнительного профессионального  образования

Челябинск, ул. Доватора, 23, телефон Тел. 8(351) 268-47-98

AIAnFokin@yandex.ruБорсукД. А.BorsukD. A.

Борсук Денис Александрович, к.м.н., ассистент  кафедры хирургии ИДПО

Челябинск

borsuk-angio@mail.ruШалдинаМ. В.ShaldinaM. V.

Шалдина Мария Викторовна, врач-сердечно-сосудистый хирург

Челябинск

m.shaldina@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Южно-Уральский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSouth Ural State Medical UniversityRussian FederationКлиника флебологии “VenoClinica” ООО «Васкулаб»РоссияPhlebology clinic “VenoClinica” LLC “Vasculab”Russian Federation2022300720231747381Copyright © Фокин А.А., Борсук Д.А., Шалдина М.В., 20222022Фокин А.А., Борсук Д.А., Шалдина М.В.Fokin A.A., Borsuk D.A., Shaldina M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cmedas.elpub.ru/jour/article/view/23

Целью настоящей работы стал комплексный анализ двухэтапной тактики лечения – изолированной эндовенозной лазерной облитерации (ЭВЛО) магистральной поверхностной вены с последующей оценкой оставленных супрафасциальных притоков и их ликвидацией в случае необходимости. Материал: в проспективное исследование включено 374 больных, перенесших 420 изолированных ЭВЛО магистральных поверхностных вен. Результаты: ко второму месяцу наблюдения на 83 (19,8%) конечностях отмечен полный регресс притоков. В 276 (65,7%) случаях отмечено значительное уменьшение количества притоков или их диаметра. На 61 (14,5%) конечности не было отмечено клинического улучшения. К шестому месяцу наблюдения в первую группу отнесены 98 (23,3%) конечностей, во вторую 265 (63,1%), и в 57 (13,6%) случаях притоки магистральных поверхностных вен оставались без изменений. Симптомы хронических заболеваний вен регрессировали на 220 (81,2%) конечностях ко второму, и на 226 (83,4%) к шестому месяцу наблюдения. Клинически значимый послеоперационный тромбофлебит развился на 46 (10,9%) конечностях. Выводы: 1) Полный регресс притоков отмечается на 19,8% конечностей ко второму, и на 23,3% к шестому месяцу наблюдения. В 63,1–65,7% случаев отмечается значительное уменьшение количества притоков или их диаметра. 2) Симптомы хронических заболеваний вен регрессируют на 83,4% конечностей. 3) Послеоперационный тромбофлебит развивается в 10,9% случаев.

The aim of this work was a comprehensive analysis of a two-stage treatment strategy - isolated endovenous laser ablation (EVLA) of the main superficial vein, followed by assessment of the left suprafascial tributaries and their elimination, if necessary. Material: in a prospective study we analyzed the results of treatment of 374 patients who had 420 EVLA of the truncal superficial veins. Results: at the second month, in 83 (19.8%) limbs was complete regression of tributaries. In 276 (65.7%) cases, a significant decrease in the number of tributaries or their diameter was noted. There was no clinical improvement in 61 (14.5%) limbs. At the sixth month 98 (23.3%) limbs were assigned to the first group, 265 (63.1%) to the second, and in 57 (13.6%) cases the tributaries remained unchanged. In 271 cases with chronic venous disorders symptoms, they regressed on 220 (81.2%) limbs at the second, and on 226 (83.4%) at the sixth month. Thrombophlebitis of the left suprafascial veins developed in 46 (10.9%) limbs. Conclusions: 1) Complete regression of tributaries was observed in 19.8% of the limbs at the second, and in 23.3% at the sixth month. In 63.1–65.7% of cases, there was a significant decrease of the number of tributaries or their diameter. 2) Symptoms of chronic venous disorders regressed in 83.4% of the extremities by the sixth month. 3) The incidence of thrombophlebitis of the tributaries was in 10.9% of cases.

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The authors declare that there are no conflicts of interest present.