摘要目的:探讨大隐静脉曲张射频闭合术的长期疗效。方法:回顾性分析首都医科大学附属北京世纪坛医院血管外科2016年7月至2017年1月采用射频闭合治疗的下肢静脉曲张185例患者（203条肢体）的临床资料。男性89例，女性96例，年龄（63.8±15.3）岁（范围：23~85岁）。术前临床表现-病因学-解剖学-病理生理学（CEAP）临床分级：C2级6例，C3级19例，C4级81例，C5级47例，C6级32例。记录患者术后不同时间的大隐静脉闭合率、CEAP临床分级、静脉临床严重程度评分（VCSS）、慢性静脉疾病生活质量量表（CIVIQ）评分、并发症等，通过重复测量方差分析评价射频闭合术的长期疗效。结果:203条肢体手术均获得成功。所有患者完成3年随访，随访时间（40.5±2.7）个月（范围：36~45个月）。1年和2年闭合率均为98.0%（199/203），3年闭合率为97.5%（198/203）。术后患者CEAP临床分级较术前降低，88.4%（76/86）的C5~C6级患者术后6个月降为C2~C4级，95.3%（82/86）的患者术后3年降为C0~C2级。患者术前及随访各个时间点的VCSS和CIVIQ评分有明显改善（VCSS： F=1 064.7， P=0.003；CIVIQ评分： F=2 984.3， P=0.001）。最常见并发症为皮下淤血，发生率为10.8%（22/203），均在术后1个月内消失，其次为色素沉着5.9%（12/203）和血栓性静脉炎3.9%（8/203）。 结论:大隐静脉曲张射频闭合术长期疗效满意。

abstractsObjective:To examine the long-term efficacy of radiofrequency closure in the treatment of great saphenous vein varicose.Methods:The clinic data of 185 patients with varicose veins of lower limbs treated with radiofrequency closure admitted at Department of Vascular Surgery, Beijing Shijitan Hospital, Capital Medical University from July 2016 to January 2017 was analyzed retrospectively. A total of 203 limbs were treated by radiofrequency closure. The long-term efficacy of radiofrequency closure was evaluated by analyzing the closure rate, clinical-etiology- anatomy-pathophysiology (CEAP) grading, venous clinical severity score (VCSS), chronic venous insufficiency questionnaire (CIVIQ) score, and complications, using repeated measures analysis of variance.Results:All procedures were successful. The closure rate was 98.0% (199/203) at one year and two years postoperative, which was still maintained at 97.5% (198/203) at 3 years of follow-up. Postoperative CEAP grading was significantly downgraded compared with that before the operation. Totally 88.4% (76/86) of C5 to C6 grade patients downgraded to C2 to C4 grade at 6 months, and 95.3% (82/86) downgraded to C0 to C2 garde at 3 years postoperative. VCSS and CIVIQ score in both groups significantly improved at all follow-up time points compared to preoperative scores (VCSS: F=1 064.7, P=0.003; CIVIQ score: F=2 984.3, P=0.001). The most common complication was subcutaneous blood stasis (10.8%), most of which disappeared within 1 month after the surgery. Other complications included pigmentation and thrombophlebitis (5.9% and 3.9%, respectively). Conclusion:The long-term efficacy of radiofrequency closure of the great saphenous vein is satisfactory.