Comparative efficacy of radiofrequency ablation versus vein stripping in chronic venous insufficiency with analysis of venous clinical severity score
RFA与静脉剥脱治疗慢性静脉功能不全疗效对比及VCSS评分分析

摘要

目的 比较射频消融（RFA）与静脉剥脱术治疗慢性静脉功能不全（CVI）的中期临床疗效，重点分析静脉临床严重程度评分（VCSS）变化和并发症发生情况。方法 采用前瞻性观察性设计，纳入2021年1月-2024年1月本院收治的81例CVI患者，根据治疗方式分为观察组（RFA治疗，40例）和对照组（静脉剥脱治疗，41例）。观察组使用美敦力ClosureFast™系统行RFA干预，对照组行标准静脉剥脱手术。术后随访至12个月，评估疗效指标。结果 术后12个月，观察组的VCSS评分改善程度显著优于对照组，差异有统计学意义（P<0.05）；观察组的并发症发生率低于对照组（P<0.05），但复发率组间无显著差异（P>0.05）。结论 RFA在改善VCSS评分、减少并发症、提升患者满意度方面优于静脉剥脱术，且复发率相当，提示RFA可作为CVI的优选微创治疗方式，但需进一步长期研究验证。

Abstract

Objective This study aimed to compare the midterm clinical outcomes of radiofrequency ablation (RFA) and vein stripping in patients with chronic venous insufficiency (CVI), focusing on changes in the Venous Clinical Severity Score (VCSS) and the incidence of complications.
Methods A prospective observational design was employed, enrolling 81 patients diagnosed with CVI at our institution between January 2021 and January 2024. Participants were categorized into an observation group (RFA, n=40) and a control group (vein stripping, n=41). The observation group underwent RFA using the Medtronic ClosureFast™ system, while the control group received conventional vein stripping surgery. Efficacy outcomes were evaluated during a 12-month postoperative follow-up period.
Results At the 12-month follow-up, the observation group demonstrated significantly greater improvement in VCSS compared to the control group (P<0.05). The complication rate was lower in the RFA group (P<0.05), although no significant difference in recurrence rate was observed between groups (P>0.05).
Conclusion   RFA outperformed vein stripping in terms of VCSS improvement, reduced complications, and enhanced patient satisfaction, while maintaining comparable recurrence rates. These findings suggest that RFA may serve as a preferred minimally invasive treatment for CVI, though further long-term studies are warranted for validation.