下肢静脉曲张泡沫硬化补充治疗时间序列分析及对凝血功能的影响

doi:10.3969/j.issn.1006-5725.2024.04.014

Abstract

Abstract:

Objective To explore the risk factors of supplementary injection after foam sclerotherapy for varicose veins of lower extremities and its impact on blood coagulation function. Methods A total of 185 patients with varicose veins of lower limbs diagnosed in the First People′s Hospital of Zunyi from January 2018 to December 2021 were selected. The corresponding pathological data were collected， and the D-dimer， thrombin time， and fibrinogen level of patients were detected 1 d before and 1 d after the surgery. The postoperative video phone follow-up lasted until 6 months after the surgery. The patients were divided into single treatment group and supplementary treatment group according to whether supplementary injection of foam sclerosing agent was needed during the follow-up. Propensity matching on the data between the two groups was conducted， and the correlation between disease course data， coagulation factors， and the occurrence of supplementary injection was analyzed. A time series model for the incidence of supplementary injection was established， and the therapeutic effect and complications were observed. Results After propensity matching， there was still significant difference in the degree of lesion between the two groups （P < 0.05）. On the first day after surgery， there was significant difference in the D-dimer and fibrinogen groups between the two groups （P < 0.05）， and but no significant difference in thrombin time （P > 0.05）. The occurrence of supplementary injection was significantly correlated with D-dimer， fibrinogen， thrombin time， and first-time injection dose （P < 0.05）， and the incidence of supplementary injection was higher in patients who received first-time injection in January， August， September， and December. Both groups achieved successful treatment 6 months after surgery， and there was no significant difference in the incidence of complications. Conclusion Patients with lower limb varicose veins of C3/C4 are more likely to require supplementary injection compared to patients with other levels. The level of D-dimer and fibrinogen at 1 d after surgery is positively correlated with the occurrence of supplementary injection， while the dose of the first injection is negatively correlated with the occurrence of supplementary injection.

Key words: varicose veins of lower extremities, foam sclerosis, time series model, coagulation, prophet model

CLC Number:

R543.6

Yiping ZHU,Tao XU,Mingmei TANG,Die YANG,Yiman XIE,Xin. TAN. Risk factors of supplementary injection after foam sclerotherapy for varicose veins of lower extremities and its impact on blood coagulation function[J]. The Journal of Practical Medicine, 2024, 40(4): 521-525.

Figures/Tables 6

Tab.1

Fig.1

Tab.2

Tab.3

Tab.4

Fig.2

References 26

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	单次治疗组（n = 116）	补充治疗组（n = 58）	U/χ²值	P值
男（例）	37	13	1.695	0.195
年龄（岁）	44（51，60）	56（45，65）	1.912	0.169
病程（年）	10（4，16）	10（5，15）	0.013	0.909
病变程度（例）			10.580	0.032
C1-C2	69	28
C3	13	17
C4	25	12
C5	8	1
C6	1	0
最大直径（mm）	6.0（5.1，7.1）	5.1（4.4，6.2）	4.324	0.040
病变位置（例）			12.800	0.002
左下肢	27	29
右下肢	50	15
双下肢	39	14

	单次治疗组（n = 52）	补充治疗组（n =52）	t/χ²值	P值
男（例）	18	12	1.686	0.194
年龄（岁）	52.50 ± 14.32	53.46 ± 11.50	0.378	0.707
病程（年）	10.69 ± 11.14	11.81 ± 9.70	0.544	0.587
病变程度（例）			11.062	0.030
C1-C2	35	26
C3	6	13
C4	5	12
C5	5	1
C6	1	0
最大直径（mm）	6.20 ± 2.54	6.09 ± 2.29	0.231	0.818
病变位置（例）			4.044	0.141
左下肢	18	24
右下肢	25	15
双下肢	9	13

组别	D-二聚体（μg/L）		纤维蛋白原（g/L）		凝血酶时间（s）
组别	术前	术后第1天	术前	术后第1天	术前	术后第1天
单次治疗组（n = 52）	319.66 ± 14.66	598.12 ± 35.59^a	3.22 ± 0.94	4.90 ± 1.29^a	14.14 ± 1.25	10.50 ± 0.92^a
补充治疗组（n = 52）	318.13 ± 20.10	628.47 ± 35.91^a	3.13 ± 0.90	6.92 ± 0.97^a	14.13 ± 1.24	9.57 ± 4.62^a
t值	0.422	7.771	0.536	9.031	0.009	1.427
P值	0.674	< 0.001	0.593	< 0.001	0.993	0.159

	D-二聚体	纤维蛋白原	凝血酶时间	首次注射剂量
r值	0.866	0.683	0.858	-0.228
P值	< 0.001	< 0.001	< 0.001	0.022

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Risk factors of supplementary injection after foam sclerotherapy for varicose veins of lower extremities and its impact on blood coagulation function

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