Objective:To compare the efficacy and quality of life of patients with lower extremity varicose veins treated by high ligation and stripping (HLS) without preservation of the great saphenous vein and endovascular radiofrequency ablation (RFA) with preservation of the below-knee great saphenous vein.Methods:The clinical data of 177 patients (217 affected limbs) with lower extremity varicose veins admitted to the Second Hospital of Shanxi Medical University and Taiyuan Central Hospital from May 2018 to April 2020 were retrospectively collected and analyzed. Among them, 90 patients (112 affected limbs) received HLS and 87 patients (105 affected limbs) received RFA. The recurrence rate within 2 years after surgery, postoperative complications, venous clinical severity score (VCSS) and Chronic Venous Insufficiency Questionnaire (CIVIQ-14) were compared between two groups using t and χ2 tests. Results:The length of hospital stay, operation time and intraoperative blood loss in RFA group were significantly less than those in HLS group [(4.67±1.11) d vs (9.34±2.24) d, t=17.523, P<0.001; (57.74±8.36) min vs (121.46±40.55) min, t=14.361, P<0.001; (11.90±3.07) ml vs (85.06±21.21) ml, t=32.378, P<0.001]. In terms of postoperative complications, limb pain and numbness were less common in the RFA group than that in the HLS group, and the differences were startistically significant (8 vs 18, χ2=4.121, P=0.042; 6 vs 16, χ2=4.812, P=0.028). However, there was no significant difference in the incidence of deep vein thrombosis, thrombophlebitis, subcutaneous hematoma, infection, skin induration, and other complications between the two groups. A total of 177 patients completed the 2-year follow-up, of which 2 patients had recurrence in HLS group and no recurrence in the RFA group. The scores of VCSS (HLS group: 5.30±1.07, 1.97±1.29, 1.87±1.31, 9.20±0.96; RFA group: 1.44±0.50, 1.11±0.69, 1.09±0.68, 9.11±0.87) and CIVIQ-14 scores (HLS group: 57.32±5.79, 61.50±5.17, 62.78±4.61, 49.43±5.42;RFA group: 65.15±2.69, 65.43±2.51, 65.72±2.33, 48.82±4.87) in the two groups at 3 months, 1 year and 2 years after operation were significantly improved compared with those before operation [(1) VCSS: HLS group: t=49.313, 48.239, 47.867, all P<0.001; RFA group: t=77.739, 72.145, 71.596, all P<0.001; (2) CIVIQ-14: HLS group: t=-12.700, -17.599, -18.922, all P<0.001; RFA group: t=-26.412, -26.814, -27.974, all P<0.001]. Compared with HLS group, the VCSS score was lower ( t=31.073, 5.469, 4.924, all P<0.001) and CIVIQ-14 score was higher ( t=11.594, -6.464, -5.394, all P<0.001) in RFA group at 3 months, 1 year and 2 years after operation, and the differences were startistically significant. Conclusion:RFA with the preservation of the below-knee great saphenous vein and HLS without the preservation of the below-knee great saphenous vein show good therapeutic effect. Compared with HLS, RFA has shorter operation time, faster postoperative recovery, fewer complications, and improved quality of life during the follow-up period, with higher patient satisfaction.

维持性血液透析目前是肾功能衰竭终末期患者的主要治疗方法.在血液透析过程中,肝素药物是主要的抗凝药物,而在使用过程中肝素诱导血小板减少症(heparin-induced thrombocytopenia,HIT)是其严重的不良反应之一,对患者的预后造成严重的影响,严重者甚至导致死亡.目前研究显示10％血液透析患者血浆中存在HIT抗体,而HIT发生率为0.5％～5.0％[1-2].本研究探讨1例维持性血液透析过程中出现HIT患者治疗过程,现报道如下.