Great saphenous varicose veins laser treatment

Keywords:varicose, veins, Laser, treatment,  Time:20-07-2015

Abstract:
Objective: to introduce the laser treatment of great saphenous varicose veins: anesthesia applied comprehensive 940 nm semiconductor laser therapeutic apparatus in the treatment of great saphenous varicose veins 26 cases. Results: the application of laser in the treatment of great saphenous vein varicose 26 cases, 30 of the limb. 4 cases were male, female, 22 cases are satisfied curative effect, no complications occurred, average in hospital for two days, followed up for 1 to 6 months with no recurrence. Conclusion: the method of using laser treatment of great saphenous varicose veins type is simple, safe, beautiful and reliable curative effect, does not affect the activity, shorter hospitalization time, patient satisfaction is high.
Keywords: great saphenous varicose veins Laser treatment


Great saphenous varicose veins is a kind of common disease, main show is phlebectasia, elongation, circuity. The early onset of patients with limb acid bilges, heavy, and a dull pain, easily spent. Late occurrence skin atrophy, desquamation, pigmentation, skin and subcutaneous induration, eczema, ulcer, even sometimes can be complicated by bleeding and thrombotic phlebitis, serious impact on the patient's life and work.
Clinical data

1. General information
Since May 2004, our hospital adopt comprehensive ChiroLas 940 nm semiconductor laser therapeutic apparatus in the treatment of great saphenous varicose veins in patients with 26 cases, 30 of the body. 4 cases were male, female 22 cases. 27-53 years old, average 35.4 years old, have a satisfactory curative effect.

2. Case selection
In this case, the history and physical examination can be confirmed. Due to limited therapeutic instrument function, at present this method is only applicable Yu Dayin venous trunk lesions of the patients. The following taboo: (1) combination of systemic disease (2) varices serious (3) high blood coagulation state (4) pregnant women (5) is generally poor. Preoperative line should be deep vein patency and deep vein valve regurgitation. With portable doppler tag vascular position, so that intraoperative accurately cut off.

3. The operation method
The surgery was performed under local anesthesia, if necessary, supplemented by intravenous anesthesia. Regular disinfection shop towels, lidocaine local infiltration anesthesia. On the medial malleolus by casing 2 cm ankle vein needle puncture, puncture is difficult to do a small incision under the direct cut open the vein, anterograde in ultra smooth godet, import 5 f vascular sheath under the inguinal ligament 2-3 cm, pulling thread, in fiber laser, laser therapeutic apparatus, the infrared guided by fiber laser head under the inguinal ligament to 2 cm in open lasers, set the transmitted power is 12 w, each pulse time to 1 second, two seconds, laser, at the same time slowly out of the laser fiber, 1 cm/SEC, helped by trip along the great saphenous vein compression with the hand, closes the venous wall, varicose of small group can block will not be processing, large mass and traffic finance excision and ligation, to reduce the recurrence. Bi limb with the elastic bandage compression bandage. Patients can get out of bed, after conventional intravenous antibiotics, patients can be discharged from hospital.

Postoperative treatment 4.
Elastic bandage compression bandage 2 weeks postoperatively, take out stitches wound 12-14 days, two weeks after the court review, some patients limb wounds. Check the presence of residual varicose, its necessary hardener injections, with elastic bandage 1 week, wear stretch hose in March. After surgery can return to work the next day, but should avoid long stand, and violent activities.

The results of
Since May 2004, I division in great saphenous varicose veins laser treatment of 26 patients, 30 of the body. 4 cases were male, female 22 cases. The average in hospital for two days. The average operation time 45 + / - 7.5 points, no complications. Postoperative follow-up between January and June, the effect is good, no recurrence.

discuss
Great saphenous varicose veins is a common disease, the current treatment methods mainly include minimally invasive surgery, curing agent treatment and traditional operation method, etc. Traditional high ligation and stripping surgery, injury of vascular bed is bigger, epidural anesthesia, patients suffering, stay in bed for a long time, the higher incidence of complications. Minimally invasive surgery with varus stripping of great saphenous vein trunk method is a traditional method to the operation of the vascular bed is small, it can be finished under local anesthesia surgery. Pure hardener treatment recurrence rate is high, organized reaction, is now rarely used alone. Laser treatment of great saphenous varicose veins without stripping the trunk. Treatment on vascular lumen is completed, will damage to a minimum. Therefore, for the main lesion severity is light a moderate compared with laser therapy and surgery has the following advantages: 1. To avoid the risks of surgery, because of the small incision, even without incision, can reduce the wound infection, the risk of bleeding and tissue damage. 2. Shorter hospitalization time, the economy.

3. Does not affect patients normal life, the patient pain is small, and beautiful. This method is the key to success is: 1. Choose the right patients, for the main pathological changes, and the degree of pathological changes the heavier patients, while it is possible to use laser processing the trunk, but should handle the traffic at the same time, along with hardener treatment. 2. When in laser fiber not fiber communication branches will miss in vein in order to avoid damage, should open the indicator light when laser fiber placement, and pay attention to whether fiber trip along the great saphenous vein and near heart not more than 2 cm under the inguinal ligament. 3. The retreat, moderate speed when the laser fiber assistant must travel along the great saphenous vein compression at the same time. 4. Postoperative limb elastic bandage compression bandage matters.

Great saphenous varicose veins laser treatment was designed by a British vascular surgeon Robert Min and first applied to clinical, 1999, our department in May 2004 the introduction of the technology, after half a year's practice, we think this method with the recent, long-term effect remains to be seen.