ĐIỀU TRỊ SUY TĨNH MẠCH NÔNG CHI dưới BẰNG PHƯƠNG PHÁP nội TĨNH MẠCH với LASER DIODE bước SÓNG 810nm

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



1
, Phan Thanh Hi
2
1
L-- Tp HCM
2
Trung tâm y khoa Medic Tp HCM


 

u
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 



 -
-
-
-
  - 


-


 

T khóa: Laser nch - i

SUMMARY
VARICOSE VEIN TREATMENT WITH ENDOVENOUS LASER THERAPY
USING AN 810nm DIODE LASER
Introduction: Ablation of varicose veins by endovenous laser therapy (EVLT) is a newer
procedure that is less invasive than surgery and has a lower complication rate. MEDIC Center is
the first institution in Vietnam where this procedure is performed. In this paper, we describe
early results obtained from 80 patients treated by EVLT
Methods: In a descriptive study, EVLT was offered to patients where preliminary ultrasound
scanning showed saphenous reflux with a straight section of diameter greater than 6 mm for
large saphenous vein and 4mm for small saphenous vein. Ultrasound surveillance was repeated
at 1 - 3 months and 1 year to confirm that the treated vein has been occluded.
Results: From 4/2008 to 8/2009, 80 cases of EVLT (95 limbs) were done with a 1 month, 3
month and 1 year follow-up at our center in 22 male and 58 female patients. Mean age was 53
years (range: 28 to 80 years). The CEAP classification was used to assess the limbs. There were
85 limbs with uncomplicated varicose veins (C23, 89.5%), 8 limbs with lipodermatosclerosis
(C4, 8.5%) and 2 limbs with skin ulceration (C6, 2%). 89 GSV and 6 SSV. Primary disease was
present in all limbs, and none had features of the post-thrombotic syndrome. EVLT was
performed using the MedArt 810 nm diode laser system. Settings were selected to deliver 10W
of power at a continuous rate. The mean operating time was 30 minutes. The postoperative
course was significantly less painful and all patients were satisfied with the cosmetic results. The
patients could walk and go home at 1 hour after procedure. There was no complication. Vein
closure occurred in 100% at 1, 3 months and 1 year by ultrasound surveillance. >90% patients
had improvement in their symptoms after treatment.
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Conclusion: Saphenous reflux was effectively controlled by EVLT as an outpatient
procedure under local anaesthesia with a lot of advantages for patients: immediate mobilisation,

minimal disruption of activities, satisfactory functional and cosmetic results and avoidance of
surgical trauma.
Key words: endovenous laser - varicose vein



                    


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i hp thc hi
u tr qua 80 b


: Mô tn 8/2009.





-

Siêu âm:





          n
(Guide-wire) 0.035, ng dn-


 dây d-
ng d
-


--
-
             

   
Energy (joules) = power (watt) x time (giây) (E=Pxt). 
ng 10W, phát sóng liên t






MedArt b 810 nm

siêu âm

d
435

4/2008-8/2009, 80 Bn v           




80 (95 chân)

 22 nam

53 (28-80)


95 chân (100%)

93 chân (98%)

5 chân (5,2%)

8 chân (8,4%)
Loét chân
2 chân (2,1%)

89 (94%)
TM hin bé


(The clinical, aetiological, anatomical, and
pathophysiological classification)
C2 = 80 (84%)
C3 = 5 (5,2%)
C4 = 8 (8,4%)
C6 = 2 (2,4%)

u tr
95


95 (100%)
n l
12mm (8-18mm)
n ln
10mm (6-16mm)

5 (5%)

32cm (10-40cm)

6,5mm (6-8mm)
ng kính thânTM hin bé
5 mm (4-6mm)
Ch
8cm (5-10cm)


80
S u tr
95

76 /80 (95%)

80 / 95 (84,5%)
T
0

0


90/95 (95%)

24/80 (30%)




80

95/95 (100%)
Không
95/95 (100%)

0
436
B
S Bn
20 (25%)
TM hin b tc và teo nh
20/20 (100%)
c
20/20 (100%)




máu

















        
               

                

            
vein).
        





               

u m











                  
437



(89 TM hi

 TM dãn bng móc vi
ng rch da nh
c thc hiy TM hin b tc và teo nh không còn thy. Các
nghiên cu trên th giu cho thy siêu âm sau 1 tháng s thy TM b tc hoàn toàn, không có
ph dòng chy, sau 3 tháng thc TM nh 


-70% sau 5  
















 v

Kho u tr 
vòng 1 tung tt vi thuc ging.



-
 u tr laser. Mt s
 co tht nhiu sa không th lun guide-wire, chúng tôi phi dùng PP
 bc l

m thc hing hp TM
xon, huyt khi TM nông gii hi ngh mch máu Châu Âu Paris 2009 và
cho kt qu rt tt [9].




i 95 TM hiu tr

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