{"id":38337,"date":"2024-07-15T05:10:11","date_gmt":"2024-07-15T05:10:11","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=38337"},"modified":"2024-07-15T05:10:11","modified_gmt":"2024-07-15T05:10:11","slug":"%e4%b8%8b%e8%82%a2%e9%9d%99%e8%84%89%e7%96%be%e7%97%85%e7%9a%84%e8%8d%af%e7%89%a9%e6%b2%bb%e7%96%97%e6%9c%80%e6%96%b0%e8%bf%9b%e5%b1%95","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=38337","title":{"rendered":"\u4e0b\u80a2\u9759\u8109\u75be\u75c5\u7684\u836f\u7269\u6cbb\u7597\u6700\u65b0\u8fdb\u5c55"},"content":{"rendered":"

\u6162\u6027\u9759\u8109\u75be\u75c5\uff08chronic venous disease\uff0cCVD\uff09\u662f\u4e00\u79cd\u5e38\u89c1\u7684\u8840\u7ba1\u75be\u75c5\uff0c\u662f\u56e0\u9759\u8109\u7684\u7ed3\u6784\u6216\u529f\u80fd\u5f02\u5e38\u4f7f\u9759\u8109\u8840\u56de\u6d41\u4e0d\u7545\u3001\u9759\u8109\u538b\u529b\u8fc7\u9ad8\u5bfc\u81f4\u7684\u4e00\u7cfb\u5217\u75c7\u72b6\u548c\u4f53\u5f81\u4e3a\u7279\u5f81\u7684\u7efc\u5408\u5f81\uff0c\u4ee5\u4e0b\u80a2\u6c89\u91cd\u3001\u75b2\u52b3\u548c\u80c0\u75db\u3001\u6c34\u80bf\u3001\u9759\u8109\u66f2\u5f20\u3001\u76ae\u80a4\u8425\u517b\u6539\u53d8\u3001\u8272\u7d20\u6c89\u7740\u548c\u9759\u8109\u6e83\u75a1\u4e3a\u4e3b\u8981\u4e34\u5e8a\u8868\u73b0[1]<\/sup>\u3002CVD\u75c5\u56e0\u590d\u6742\uff0c\u65e2\u5f80\u7814\u7a76\u8868\u660e\uff0cCVD\u7684\u53d1\u75c5\u673a\u5236\u4e3b\u8981\u4e0e\u4e0b\u80a2\u9759\u8109\u9ad8\u538b\u3001\u6162\u6027\u708e\u75c7\u53cd\u5e94\u3001\u9759\u8109\u5fae\u5faa\u73af\u53d7\u635f\u4ee5\u53ca\u9057\u4f20\u6613\u611f\u6027\u7b49\u56e0\u7d20\u6709\u5173[2]<\/sup>\u3002CVD\u7684\u6cbb\u7597\u65b9\u5f0f\u5305\u62ec\u836f\u7269\u6cbb\u7597\u3001\u538b\u529b\u6cbb\u7597\u3001\u786c\u5316\u5242\u6cbb\u7597\u4ee5\u53ca\u624b\u672f\u6cbb\u7597\u7b49\u7efc\u5408\u6cbb\u7597\u624b\u6bb5\u3002\u8fd1\u5e74\u6765\uff0c\u836f\u7269\u6cbb\u7597\u7684\u91cd\u8981\u6027\u4e5f\u65e5\u76ca\u53d7\u5230\u91cd\u89c6\uff0c\u836f\u7269\u8054\u5408\u538b\u529b\u6cbb\u7597\u548c\uff08\u6216\uff09\u624b\u672f\u7684\u7efc\u5408\u6cbb\u7597\u65b9\u6848\u5df2\u6210\u4e3a\u65b0\u7684\u8d8b\u52bf\uff0c\u53ef\u663e\u8457\u904f\u5236\u548c\u7f13\u89e3\u9759\u8109\u66f2\u5f20\u7684\u75c5\u7406\u751f\u7406\uff0c\u540c\u65f6\u8fd8\u53ef\u8fdb\u4e00\u6b65\u5de9\u56fa\u624b\u672f\u7597\u6548[3]<\/sup>\u3002<\/p>\n

2023\u5e747\u6708\uff0c\u8840\u7ba1\u5916\u79d1\u5b66\u4f1a(SVS)\u3001\u7f8e\u56fd\u9759\u8109\u8bba\u575b(AVF)\u548c\u7f8e\u56fd\u9759\u8109\u548c\u6dcb\u5df4\u5b66\u4f1a(AVLS)\u8054\u5408\u66f4\u65b0\u4e86\u4e0b\u80a2\u9759\u8109\u66f2\u5f20\u6cbb\u7597\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u7684\u7b2c\u4e8c\u90e8\u5206\uff08\u4ee5\u4e0b\u7b80\u79f0\u201c2023\u7248\u65b0\u6307\u5357\u201d\uff09\uff0c\u91cd\u70b9\u805a\u7126\u4e8e\u9759\u8109\u66f2\u5f20\u60a3\u8005\u7684\u9884\u9632\u548c\u7ba1\u7406\uff0c\u538b\u529b\u6cbb\u7597\u4e0e\u836f\u7269\u548c\u8425\u517b\u4f9b\u7ed9\uff0c\u8bc4\u4ef7\u548c\u6cbb\u7597\u9759\u8109\u66f2\u5f20\u7684\u5c5e\u652f\u53ca\u6d45\u9759\u8109\u7624\uff0c\u4ee5\u53ca\u9759\u8109\u66f2\u5f20\u7684\u5e76\u53d1\u75c7\u548c\u6cbb\u7597\u7684\u7ba1\u7406[4]<\/sup>\u3002\u5176\u4e2d\u5728\u836f\u7269\u6cbb\u7597\u65b9\u9762\uff0c2023\u7248\u65b0\u6307\u5357\u6307\u51fa\uff1a<\/p>\n

\u5bf9\u4e8e\u4e0d\u9002\u5408\u5e72\u9884\u7684\u6709\u75c7\u72b6\u7684\u9759\u8109\u66f2\u5f20\u60a3\u8005\uff0c\u6216\u6b63\u5728\u7b49\u5f85\u5e72\u9884\u6216\u5e72\u9884\u540e\u51fa\u73b0\u75c7\u72b6\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u4f7f\u7528\u67d1\u6a58\u9ec4\u916e\u7247\uff08\u5fae\u7c92\u5316\u7eaf\u5316\u9ec4\u916e\uff09(MPFF)\u6216\u5047\u53f6\u6811\u63d0\u53d6\u7269\u6cbb\u7597\u9759\u8109\u76f8\u5173\u75bc\u75db\uff0c\u817f\u90e8\u6c89\u91cd\u611f\u548c\/\u6216\u80bf\u80c0\u611f\u3002\u7ed9\u4e882B\u63a8\u8350\u3002<\/p>\n

\u5bf9\u4e8e\u4e0d\u9002\u5408\u5e72\u9884\u7684\u6709\u75c7\u72b6\u7684\u9759\u8109\u66f2\u5f20\u60a3\u8005\uff0c\u6216\u6b63\u5728\u7b49\u5f85\u5e72\u9884\u6216\u5e72\u9884\u540e\u51fa\u73b0\u75c7\u72b6\u7684\u60a3\u8005\uff0c\u6307\u5357\u5efa\u8bae\u4f7f\u7528\u7f9f\u4e59\u57fa\u82a6\u4e01\u3001\u7f9f\u82ef\u78fa\u9178\u9499\u3001\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u3001\u7ea2\u85e4\u53f6\u63d0\u53d6\u7269\u6216\u8212\u6d1b\u5730\u7279\u6cbb\u7597\u9759\u8109\u76f8\u5173\u6027\u75bc\u75db\u3001\u817f\u90e8\u6c89\u91cd\u611f\u3001\u591c\u95f4\u75c9\u631b\u548c\/\u6216\u80bf\u80c0\u611f\u3002\u7ed9\u4e882C\u63a8\u8350\u3002<\/p>\n

\u76ee\u524d\u7528\u4e8e\u6162\u6027\u9759\u8109\u75be\u75c5\u6cbb\u7597\u7684\u836f\u7269\u53ef\u5206\u4e3a\uff1a\u9759\u8109\u6d3b\u6027\u836f\u7269\uff08venoactive drug\uff0cVAD\uff09\u3001\u5f71\u54cd\u8840\u6db2\u6d41\u53d8\u7279\u6027\u7684\u836f\u7269\u548c\u5176\u4ed6\u836f\u7269\u30022023\u7248\u65b0\u6307\u5357\u4e2d\u63a8\u8350\u7684\u5047\u53f6\u6811\u63d0\u53d6\u7269\u3001\u7f9f\u82ef\u78fa\u9178\u9499\u3001\u7ea2\u85e4\u53f6\u63d0\u53d6\u7269\u5bf9\u4e8eCVD\u75c7\u72b6\u7684\u6539\u5584\u6709\u4e00\u5b9a\u7684\u4f5c\u7528\uff0c\u4f46\u662f\u5728\u56fd\u5916\u5e7f\u6cdb\u4f7f\u7528\u3002\u8003\u8651\u5230\u4e2d\u56fd\u4f7f\u7528\u7684\u836f\u7269\u4e3b\u8981\u662f\u67d1\u6a58\u9ec4\u916e\u7247\u3001\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u3001\u8212\u6d1b\u5730\u7279\uff0c\u672c\u6587\u8f83\u591a\u8ba8\u8bba\u8fd9\u51e0\u79cd\u836f\u7269\u3002<\/p>\n

\u201c<\/p>\n

1. \u9759\u8109\u6d3b\u6027\u836f\u7269<\/p>\n

\u9759\u8109\u6d3b\u6027\u836f\u7269\uff08venoactive drug\uff0cVAD\uff09\u662f\u836f\u7269\u6cbb\u7597\u7684\u91cd\u8981\u90e8\u5206\uff0c\u5305\u62ec\u5929\u7136\u548c\u4eba\u5de5\u5408\u6210\u4e24\u7c7b\uff0c\u53ef\u7528\u4e8e\u89e3\u9664\u60a3\u8005\u7684\u4e0b\u80a2\u6c89\u91cd\u3001\u9178\u80c0\u4e0d\u9002\u3001\u75bc\u75db\u548c\u6c34\u80bf\u7b49\u4e34\u5e8a\u8868\u73b0\uff0c\u9002\u7528\u4e8e\u6162\u6027\u9759\u8109\u75be\u75c5\u6240\u6709\u9636\u6bb5[2]<\/sup>\u3002VAD\u7684\u4e3b\u8981\u4f5c\u7528\u65b9\u5f0f\u662f\u964d\u4f4e\u6bdb\u7ec6\u8840\u7ba1\u901a\u900f\u6027\uff0c\u51cf\u5c11\u708e\u6027\u4ecb\u8d28\u91ca\u653e\u6216\u6539\u5584\u9759\u8109\u5f20\u529b\u3002<\/p>\n

1.1 \u67d1\u6a58\u9ec4\u916e\u7247<\/p>\n

\u67d1\u6a58\u9ec4\u916e\u7247\u662f\u9ec4\u916e\u7c7b\u7684\u4ee3\u8868\u836f\u7269\uff0c\u65e2\u5f80\u7684\u7814\u7a76\u8bc1\u5b9e\u4e86\u67d1\u6a58\u9ec4\u916e\u7247\uff08MPFF\uff09\u5bf9\u4e8eC0-C6\u60a3\u8005\u4e34\u5e8a\u8868\u73b0\u6539\u5584\u7684\u6709\u6548\u6027\uff0c\u67d1\u6a58\u9ec4\u916e\u7247\uff08MPFF\uff09\u5728\u817f\u90e8\u4f53\u79ef\u51cf\u5c0f\u3001\u75bc\u75db\u548c\u6539\u5584\u751f\u6d3b\u8d28\u91cf\u65b9\u9762\u5177\u6709\u4f18\u8d8a\u7684\u6548\u679c\u3002\u67d1\u6a58\u9ec4\u916e\u7247\uff08MPFF\uff09\u7684\u4e3b\u8981\u6210\u5206\u5730\u5965\u53f8\u660e\u5355\u72ec\u6709\u6548\uff0c\u4f46\u5730\u5965\u53f8\u660e\u5355\u72ec\u7597\u6548\u660e\u663e\u4f4e\u4e8e\u67d1\u6a58\u9ec4\u916e\u7247\uff08MPFF\uff09[5]<\/sup>\u3002\u6b27\u6d32\u9759\u8109\u8bba\u575b\u6307\u5357\u548c\u7f8e\u56fd\u9759\u8109\u8bba\u575b\u6307\u5357\u63a8\u8350\u91c7\u7528MPFF\u6216\u5df2\u916e\u53ef\u53ef\u78b1\u8054\u5408\u538b\u8feb\u7597\u6cd5\u6cbb\u7597\u9759\u8109\u6027\u6e83\u75a1\uff08\u6e83\u75a1\u9762\u79ef5~10cm\u00b2\uff09[1,6]<\/sup>\u3002<\/p>\n

\u8fd1\u5e74\u67d1\u6a58\u9ec4\u916e\u76f8\u5173\u7684\u7814\u7a76\u6301\u7eed\u4e0d\u65ad\uff0cVEIN STEP\u662f\u4e00\u9879\u56fd\u9645\u6027\u3001\u89c2\u5bdf\u6027\u3001\u524d\u77bb\u6027\u771f\u5b9e\u4e16\u754c\u7814\u7a76\uff0c\u57289\u4e2a\u56fd\u5bb6\u62db\u52df7000\u540d\u6162\u6027\u9759\u8109\u75be\u75c5\u60a3\u8005\uff0c\u8bc4\u4f30\u4fdd\u5b88\u6cbb\u7597\u7f13\u89e3CVD\u75c7\u72b6\u7684\u6709\u6548\u6027\u53ca\u5176\u5bf9\u751f\u6d3b\u8d28\u91cf(QOL)\u7684\u5f71\u54cd\u3002\u6469\u6d1b\u54e5\u6570\u636e\u7684\u521d\u6b65\u7ed3\u679c\u8868\u660eMPFF\u6cbb\u7597\u540e\u75c7\u72b6\u51cf\u8f7b\uff0c\u60a3\u8005\u6ee1\u610f\u5ea6\u63d0\u9ad8[7]<\/sup>\u3002VEIN STEP\u4e2d\u56fd\u6570\u636e\u663e\u793a\u76f8\u6bd4\u4e8e\u5730\u5965\u53f8\u660e\uff0c\u67d1\u6a58\u9ec4\u916e\u7247\u66f4\u52a0\u663e\u8457\u7684\u6539\u5584\u60a3\u8005\u751f\u6d3b\u8d28\u91cf\u548cVCSS\u8bc4\u5206[8]<\/sup>\u3002\u4e00\u9879\u9759\u8109\u9ad8\u538b\u4ed3\u9f20\u6a21\u578b\u5b9e\u9a8c\u663e\u793a\uff0c\u67d1\u6a58\u9ec4\u916e\u80fd\u591f\u6709\u6548\u51cf\u5c11\u9759\u8109\u9ad8\u538b\u6a21\u578b\u4e2d\uff0c\u767d\u7ec6\u80de\u5bf9\u9759\u8109\u58c1\u7684\u7c98\u9644\uff0c\u4ece\u5fae\u89c2\u5c42\u9762\u89e3\u91ca\u4e86\u5176\u5bf9\u4e8e\u6162\u6027\u9759\u8109\u75be\u75c5\u4e34\u5e8a\u8868\u73b0\u6539\u5584\u7684\u673a\u5236[9]<\/sup>\u3002<\/p>\n

1.2 \u7f9f\u82ef\u78fa\u9178\u9499<\/p>\n

\u7f9f\u82ef\u78fa\u9178\u9499\u662f\u4e00\u79cd\u5177\u6709\u8840\u7ba1\u4fdd\u62a4\u548c\u6297\u8840\u6813\u4f5c\u7528\u7684\u5408\u6210\u836f\u7269\uff0c\u5b83\u53ef\u6539\u5584\u6216\u7ef4\u6301\u8840\u7ba1\u5185\u76ae\u529f\u80fd\uff0c\u964d\u4f4e\u6bdb\u7ec6\u8840\u7ba1\u9ad8\u901a\u900f\u6027\uff0c\u6291\u5236\u8840\u5c0f\u677f\u805a\u96c6\uff0c\u5e76\u964d\u4f4e\u8840\u6db2\u9ecf\u5ea6\u3002\u4e00\u9879\u7eb3\u516510\u9879RCT\u7814\u7a76\u5171778\u4f8b\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u8868\u660e\uff0c\u8be5\u7c7b\u836f\u7269\u53ef\u660e\u663e\u51cf\u8f7b\u817f\u90e8\u75c7\u72b6\u548c\u4e0d\u9002\u611f\uff0c\u4e0b\u80a2\u6c34\u80bf\u5f97\u5230\u6539\u5584\uff0c\u5c3d\u7ba1\u5b58\u5728\u4e00\u5b9a\u7684\u5f02\u8d28\u6027\uff1b\u540c\u65f6\uff0c\u4e9a\u7ec4\u5206\u6790\u8fd8\u663e\u793a\uff0c\u4e0e\u75c7\u72b6\u548c\u4f53\u5f81\u8f83\u8f7b\u7684\u60a3\u8005\u76f8\u6bd4\uff0c\u75c7\u72b6\u548c\u4f53\u5f81\u8f83\u91cd\u7684\u60a3\u8005\u5728\u75bc\u75db\u3001\u6c89\u91cd\u611f\u3001\u611f\u89c9\u5f02\u5e38\u548c\u817f\u90e8\u6c34\u80bf\u65b9\u9762\u6709\u66f4\u660e\u663e\u7684\u6539\u5584[10]<\/sup>\u3002<\/p>\n

\u53e6\u5916\uff0c\u9488\u5bf9CVD\u75c5\u7406\u751f\u7406\u673a\u5236\u7684\u7814\u7a76\u8868\u660e\uff0c\u7f9f\u82ef\u78fa\u9178\u9499\u5728\u4f53\u5916\u53ef\u4ee5\u6291\u5236\u5fae\u7c92\u4f53\u524d\u5217\u817a\u7d20\u7684\u5408\u6210\uff0c\u51cf\u8f7b\u4e0b\u80a2\u6c34\u80bf\uff0c\u6539\u5584CVD\u75c7\u72b6[11]<\/sup>\u30023\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a76\u8bc4\u4f30\u4e86\u5728\u7f9f\u82ef\u78fa\u9178\u9499\u6cbb\u75974\uff5e8\u5468\u540eCVD\u60a3\u8005\u7684\u5c0f\u817f\u4f53\u79ef\uff0c\u4e0e\u670d\u7528\u5b89\u6170\u5242\u7684\u60a3\u8005\u76f8\u6bd4\uff0c\u4f7f\u7528\u7f9f\u82ef\u78fa\u9178\u9499\u7684\u60a3\u8005\u817f\u90e8\u6c34\u80bf\u663e\u8457\u51cf\u8f7b[12-14]<\/sup>\u3002\u5bf9\u8fd9\u4e9b\u4e34\u5e8a\u7ed3\u679c\u7684\u7efc\u5408\u5206\u6790\u663e\u793a\uff0c\u7f9f\u82ef\u78fa\u9178\u9499\u4e3b\u8981\u6539\u5584\u817f\u90e8\u6c34\u80bf\uff0c\u817f\u90e8\u75bc\u75db\u4ee5\u53ca\u4e0d\u5b81\u817f[15]<\/sup>\u3002\u4f46\u4e5f\u6709\u8bd5\u9a8c\u663e\u793a\u5176\u7597\u6548\u4e0d\u4f73\uff0c\u57281\u9879\u5171\u7eb3\u5165500\u591a\u4f8bCVD\u60a3\u8005\u7684\u968f\u673a\u5bf9\u7167\u7814\u7a76\u4e2d\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u7f9f\u82ef\u78fa\u9178\u9499\u6cbb\u75973\u4e2a\u6708\u5728\u817f\u90e8\u6c34\u80bf\u3001CVD\u75c7\u72b6\u6216\u751f\u6d3b\u8d28\u91cf\u65b9\u9762\u672a\u83b7\u5f97\u663e\u8457\u6539\u5584[16]<\/sup>\u3002<\/p>\n

1.3 \u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269<\/p>\n

\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u7684\u6709\u6548\u6210\u4efd\u4e3a\u4e03\u53f6\u7682\u82f7\uff0c\u5177\u6709\u6291\u5236\u5f39\u6027\u86cb\u767d\u9176\u548c\u900f\u660e\u8d28\u9178\u9176\u7684\u6d3b\u6027\uff0c\u8fd92\u79cd\u9176\u53c2\u4e0e\u86cb\u767d\u591a\u7cd6\u7684\u964d\u89e3\uff08\u5206\u89e3\u590d\u6742\u86cb\u767d\u5206\u5b50\u7684\u8fc7\u7a0b\uff09\u3002\u767d\u7ec6\u80de\u5728\u6162\u6027\u9759\u8109\u529f\u80fd\u4e0d\u5168\uff08chronic venous insufficiency\uff0cCVI\uff09\u60a3\u80a2\u4e2d\u7684\u79ef\u805a\u4ee5\u53ca\u968f\u540e\u5f39\u6027\u86cb\u767d\u9176\u548c\u900f\u660e\u8d28\u9178\u9176\u7684\u6fc0\u6d3b\u548c\u91ca\u653e\u88ab\u8ba4\u4e3a\u662fCVI\u7684\u91cd\u8981\u53d1\u75c5\u673a\u5236\u3002\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u901a\u8fc7\u963b\u6b62\u767d\u7ec6\u80de\u6d3b\u5316\u53d1\u6325\u4f5c\u7528\uff0c\u5bf9CVI \u60a3\u8005\u7684\u5b89\u5168\u6027\u548c\u6709\u6548\u6027\u5df2\u5f97\u5230\u8bc1\u5b9e[17]<\/sup>\u3002<\/p>\n

2012\u5e74\uff0cCochrane\u7cfb\u7edf\u7efc\u8ff0\u5171\u7eb3\u516517\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff0c\u6bd4\u8f83\u5355\u836f\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u4e0e\u5b89\u6170\u5242\u6216\u5176\u4ed6\u7597\u6cd5\u76f8\u6bd4\uff0c\u5728\u6539\u5584CVI\u60a3\u8005\u817f\u90e8\u75bc\u75db\u3001\u7619\u75d2\u3001\u80bf\u80c0\u3001\u817f\u90e8\u4f53\u79ef\u548c\u5468\u957f\u7b49\u75c7\u72b6\u65b9\u9762\u7684\u83b7\u76ca\u30027\u9879\u7814\u7a76\u8bc4\u4f30\u4e86\u817f\u75db\uff0c\u5176\u4e2d6\u9879\u7814\u7a76\u663e\u793a\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u7ec4\u7684\u817f\u90e8\u75bc\u75db\u660e\u663e\u51cf\u8f7b\uff1b\u53e61\u9879\u7814\u7a76\u62a5\u544a\u4e86\u7edf\u8ba1\u5b66\u610f\u4e49\u4e0a\u7684\u663e\u8457\u6539\u5584\u30026\u9879\u7814\u7a76\uff08n=502\uff09\u8bc4\u4f30\u4e86\u817f\u7684\u5468\u957f\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u7ec4\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\u66f4\u4f18\uff0c\u5bf9\u4e8e\u6539\u5584\u4e0b\u80a2\u75bc\u75db\u3001\u6c34\u80bf\u3001\u7619\u75d2\u7b49CVI\u75c7\u72b6\u6709\u663e\u8457\u6548\u679c\uff0c\u6cbb\u75972\u5468\u540e\u53ef\u663e\u8457\u7f29\u5c0f\u4e0b\u80a2\u4f53\u79ef\uff08p\uff1c0.05\uff09\u30021\u9879\u7814\u7a76\u663e\u793a\uff0c\u9a6c\u6817\u79cd\u5b50\u63d0\u53d6\u7269\u53ef\u80fd\u4e0e\u52a0\u538b\u6cbb\u7597\u4e00\u6837\u6709\u6548\uff0c\u4e0d\u826f\u4e8b\u4ef6\u66f4\u52a0\u5c11\u89c1[17]<\/sup>\u3002<\/p>\n

1.4 \u5047\u53f6\u6811\u63d0\u53d6\u7269<\/p>\n

\u5047\u53f6\u6811\u63d0\u53d6\u7269\u5177\u6709\u6297\u708e\u3001\u51cf\u8f7b\u6c34\u80bf\u7b49\u7279\u6027\u3002\u4e00\u9879\u5173\u4e8e\u5047\u53f6\u6811\u63d0\u53d6\u7269\u7684\u7cfb\u7edf\u7efc\u8ff0\u7eb3\u5165\u4e8610\u9879\u53cc\u76f2\u968f\u673a\u5b89\u6170\u5242\u5bf9\u7167\u7814\u7a76\uff0c\u5171719 \u540d\u5355\u4fa7\u6216\u53cc\u4fa7 CVD\uff08\u60a3\u80a2CEAP\u4e34\u5e8a\u5206\u7ea7C2-C5\uff09\u60a3\u8005\u3002\u5728\u5b9a\u91cf\u5206\u6790\u4e2d\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u5047\u53f6\u6811\u63d0\u53d6\u7269\u663e\u8457\u6539\u5584\u4e86\u591a\u79cd\u817f\u90e8\u75c7\u72b6\uff0c\u5305\u62ec\u75bc\u75db\u3001\u6c89\u91cd\u3001\u75b2\u52b3\u3001\u80bf\u80c0\u611f\u3001\u75c9\u631b\u3001\u611f\u89c9\u5f02\u5e38\u3001\u5168\u8eab\u75c7\u72b6\u4ee5\u53ca\u8e1d\u56f4\u548c\u817f\/\u8db3\u90e8\u4f53\u79ef\u7b49\u4e34\u5e8a\u8868\u73b0[18]<\/sup>\u3002<\/p>\n

1.5 \u7f9f\u4e59\u57fa\u82a6\u4e01<\/p>\n

\u7f9f\u4e59\u57fa\u82a6\u4e01\u53ef\u7f13\u89e3\u75bc\u75db\u3001\u62bd\u7b4b\u3001\u4e0b\u80a2\u6c89\u91cd\u611f\u7b49\u6162\u6027\u9759\u8109\u529f\u80fd\u4e0d\u5168\u75c7\u72b6\u3002\u4e00\u9879\u7efc\u8ff0\u663e\u793a\uff0c\u7f9f\u4e59\u57fa\u82a6\u4e01\u8054\u5408\u538b\u529b\u548c\/\u6216\u5c40\u90e8\u6cbb\u7597\u4e0b\u80a2\u9759\u8109\u6027\u6e83\u75a1(VLUs)\uff0c\u4f18\u4e8e\u5355\u7eaf\u538b\u529b\u548c\/\u6216\u5c40\u90e8\u6cbb\u7597[19]<\/sup>\u3002\u53e6\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u548c\u835f\u8403\u5206\u6790\u7eb3\u516515\u9879\u7814\u7a76\u51711643\u4f8b\u60a3\u8005\uff0c\u5206\u6790\u4e86\u7f9f\u4e59\u57fa\u82a6\u4e01\u7684\u7597\u6548\uff0c\u7ed3\u679c\u53d1\u73b0\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u7f9f\u4e59\u57fa\u82a6\u4e01\u53ef\u663e\u8457\u6539\u5584CVD\u60a3\u8005\u7684\u817f\u90e8\u6c89\u91cd\u611f\u548c\u75c9\u631b\u611f\uff0c\u4f46\u5728\u7619\u75d2\u611f\u548c\u80bf\u80c0\u611f\u4e0a\u6ca1\u6709\u663e\u8457\u6027\u5dee\u5f02[20]<\/sup>\u3002<\/p>\n

1.6 \u7ea2\u85e4\u53f6\u63d0\u53d6\u7269<\/p>\n

\u7ea2\u85e4\u53f6\u63d0\u53d6\u7269\u5df2\u88ab\u8bc1\u660e\u5bf9\u9759\u8109\u5185\u819c\u5177\u6709\u4fdd\u62a4\u4f5c\u7528\uff0c\u540c\u65f6\u517c\u5177\u6297\u708e\u548c\u6291\u5236\u8840\u6813\u5f62\u6210\u7684\u7279\u6027[21]<\/sup>\u3002\u7ea2\u85e4\u53f6\u63d0\u53d6\u7269\u7684\u7597\u6548\u5df2\u7ecf\u57282\u9879RCT\u7814\u7a76\u4e2d\u5f97\u5230\u4e86\u8bc4\u4f30\uff0c\u7814\u7a76\u5206\u522b\u5305\u62ec260\u548c248\u4f8b\u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u76f8\u6bd4\u5b89\u6170\u5242\uff0c\u8be5\u7c7b\u836f\u7269\u53ef\u660e\u663e\u51cf\u5c11CVD\u76f8\u5173\u75c7\u72b6\u548c\u4e0b\u80a2\u6c34\u80bf\uff0c\u4f46\u4e24\u9879\u7814\u7a76\u4e2d\u5747\u4ec5\u6709\u75bc\u75db\u5f97\u5230\u6539\u5584[22,23]<\/sup>\u3002\u53e6\u4e00\u9879\u4ea4\u53c9\u53cc\u76f2RCT\u7814\u7a76\u8bc4\u4f30\u4e86\u6c34\u80bf\u7684\u5ba2\u89c2\u5ea6\u91cf\u6307\u6807\u548c\u60a3\u8005\u7684\u6574\u4f53\u7597\u6548\uff0c\u5747\u652f\u6301\u8be5\u836f\u7269\u7684\u7597\u6548\u662f\u79ef\u6781\u7684[24]<\/sup>\u3002<\/p>\n

1.7 \u9999\u8c46\u7d20\u7c7b<\/p>\n

\u9999\u8c46\u7d20\u7c7b\u836f\u7269\u6765\u6e90\u4e8e\u8349\u6728\u7280\u690d\u7269\u63d0\u53d6\u7269\uff0c\u53ef\u964d\u4f4e\u6bdb\u7ec6\u8840\u7ba1\u901a\u900f\u6027\uff0c\u6539\u5584\u8840\u6db2\u5faa\u73af\uff0c\u589e\u52a0\u8840\u6d41\u91cf\uff0c\u4fc3\u8fdb\u6dcb\u5df4\u56de\u6d41\uff0c\u6709\u6548\u51cf\u8f7b\u6c34\u80bf[25]<\/sup>\u3002<\/p>\n

\u201c<\/p>\n

2. \u5f71\u54cd\u8840\u6db2\u6d41\u53d8\u7279\u6027\u7684\u836f\u7269<\/p>\n

\u8be5\u7c7b\u836f\u7269\u53ef\u4ee5\u4f7f\u5c40\u90e8\u8840\u6db2\u5faa\u73af\u5f97\u5230\u6539\u5584\uff0c\u76ae\u80a4\u635f\u5bb3\u5f97\u5230\u9006\u8f6c\uff0c\u5bf9\u8102\u6027\u786c\u76ae\u75c5\u7684\u708e\u75c7\u53cd\u5e94\u548c\u7ec4\u7ec7\u786c\u5316\u5177\u6709\u8f83\u597d\u7684\u7597\u6548\uff0c\u4ee3\u8868\u836f\u7269\u6709\u8212\u6d1b\u5730\u7279\u3001\u5df2\u916e\u53ef\u53ef\u78b1\u3001\u53f8\u5766\u5511\u9187\u3002<\/p>\n

2.1\u8212\u6d1b\u5730\u7279<\/p>\n

\u8212\u6d1b\u5730\u7279\u5177\u6709\u6297\u8840\u6813\u6d3b\u6027\u548c\u6fc0\u6d3b\u7ea4\u6eb6\u9176\u539f\u6d3b\u6027\u4ee5\u53ca\u5176\u4ed6\u836f\u7406\u4f5c\u7528\u3002\u5bf9\u8212\u6d1b\u5730\u727913\u9879\u7814\u7a76\u8fdb\u884c\u4e86\u7cfb\u7edf\u56de\u987e\u548c\u835f\u8403\u5206\u6790\uff0c\u5171\u7eb3\u5165\u4e861901\u540d\u5904\u4e8eCVD\u4efb\u4f55\u9636\u6bb5\u7684\u53d7\u8bd5\u8005\uff0c\u65e0\u8bba\u662f\u539f\u53d1\u7684\u8fd8\u662f\u7ee7\u53d1\u7684\u3002\u8212\u6d1b\u5730\u7279\u964d\u4f4e\u4e86CVD\u60a3\u8005\u7684\u75bc\u75db\u3001\u75c9\u631b\u3001\u6c89\u91cd\u3001\u6c34\u80bf\u7684\u5f3a\u5ea6\u3001\u51cf\u5c11\u603b\u75c7\u72b6\u8bc4\u5206\u548c\u708e\u75c7[26]<\/sup>\u300210%\u7684\u60a3\u8005\u51fa\u73b0\u8f7b\u5ea6\u81f3\u4e2d\u5ea6\u80c3\u80a0\u9053\u4e0d\u826f\u53cd\u5e94\uff0c\u4f46\u572872\u5c0f\u65f6\u540e\u65e0\u9700\u5e72\u9884\u5373\u53ef\u6d88\u9000\uff0c\u5e76\u4e14\u4e0d\u9700\u8981\u505c\u6b62\u6cbb\u7597[27]<\/sup>\u3002\u4e00\u7bc7\u7eb3\u51653\u9879\u8bd5\u9a8c\u7684Meta\u5206\u6790\u663e\u793a\uff0c\u4e0e\u5355\u7eaf\u5c40\u90e8\u6cbb\u7597\uff08\u4f24\u53e3\u62a4\u7406\u548c\u52a0\u538b\u7597\u6cd5\uff09\u76f8\u6bd4\uff0c\u8f85\u4ee5\u8212\u6d1b\u5730\u7279\u6cbb\u7597\u53ef\u589e\u52a0\u6e83\u75a1\u5b8c\u5168\u6108\u5408\u7684\u60a3\u8005\u6bd4\u4f8b \uff0849. 4%\u6bd429.8%\uff09[28]<\/sup>\uff0c\u4e00\u9879\u5927\u578b\u8bd5\u9a8c\u7eb3\u5165230\u4f8b\u60a3\u8005\uff0c\u53d1\u73b0\u8212\u6d1b\u5730\u7279\u5bf9\u4e8e\u9762\u79ef\u5c0f\u4e8e10cm\u00b2\uff0c\u53d1\u751f\u65f6\u95f4\u76f8\u5bf9\u4e0d\u957f\uff08\u81f3\u591a12\u4e2a\u6708\uff09\u7684\u6e83\u75a1\u6548\u679c\u66f4\u4f73[29]<\/sup>\u3002<\/p>\n

SUAVIS\u662f\u4e00\u9879\u53cc\u76f2\u3001\u591a\u4e2d\u5fc3\u3001\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff0c\u8bc4\u4f30\u4e86\u8212\u6d1b\u5730\u7279\u5bf9235\u4f8b\u76f4\u5f84>2cm\u7684\u9759\u8109\u6e83\u75a1\u60a3\u8005\u7684\u6cbb\u7597\u6548\u679c\u3002\u8212\u6d1b\u5730\u7279\u7ec4\u57282\u4e2a\u6708(35.0% vs 20.9%\uff0cP=0.018)\u548c3\u4e2a\u6708(52.5% vs 32.7%\uff0cP=0.004)\u65f6\u7684\u5b8c\u5168\u6e83\u75a1\u6108\u5408\u7387\u9ad8\u4e8e\u5b89\u6170\u5242\u7ec4[30]<\/sup>\u3002\u9274\u4e8e\u5bf9\u8212\u6d1b\u5730\u7279\u63d0\u9ad8\u6cbb\u6108\u7387\u7684\u53d1\u73b0\uff0c\u8840\u7ba1\u5916\u79d1\u5b66\u4f1a\u548c\u7f8e\u56fd\u9759\u8109\u8bba\u575b\u63a8\u8350\u5c06\u8212\u6d1b\u5730\u7279\u4f5c\u4e3a\u9759\u8109\u6e83\u75a1\u60a3\u8005\u7684\u836f\u7269\u6cbb\u7597[31]<\/sup>\u3002\u53e6\u5916\u5728CVD\u771f\u5b9e\u4e16\u754c\u7814\u7a76\u4e2d\uff0c\u8212\u6d1b\u5730\u7279\u80fd\u591f\u663e\u8457\u6539\u5584CVD\u60a3\u8005\u5404\u9879\u75c7\u72b6\u548c\u4f53\u5f81[32]<\/sup>\u3002\u5bf9\u4f34\u4e0b\u80a2\u7f3a\u8840CVD\u7684\u6cbb\u7597\uff0c\u76f8\u5173\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u8212\u6d1b\u5730\u7279\u6cbb\u75973\u4e2a\u6708\u663e\u8457\u6539\u5584\u6240\u6709\u5ba2\u89c2\u548c\u4e3b\u89c2\u75c7\u72b6( p<0.0001)\uff0c\u751f\u6d3b\u95ee\u5377\u8c03\u67e5\uff1a\u75bc\u75db\uff08P\uff09\u548c\u529f\u80fd\uff08F\uff09\u4e5f\u5f97\u5230\u660e\u663e\u6539\u5584[33]<\/sup>\u3002<\/p>\n

2.2\u5df1\u916e\u53ef\u53ef\u78b1<\/p>\n

\u5df1\u916e\u53ef\u53ef\u78b1\u4e3a\u975e\u7279\u5f02\u6027\u78f7\u9178\u4e8c\u916f\u9176\u6291\u5236\u5242\uff0c\u5177\u6709\u6539\u5584\u5fae\u5faa\u73af\u7684\u4f5c\u7528[34]<\/sup>\u3002\u57282012\u5e74\u7684Cochrane\u7efc\u8ff0\u4e2d[35]<\/sup>\uff0c11\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u663e\u793a\uff0c\u5355\u72ec\u4f7f\u7528\u5df2\u916e\u53ef\u53ef\u78b1\u6bd4\u5b89\u6170\u5242\u66f4\u6709\u6548\u5730\u5b8c\u5168\u6108\u5408\u6216\u663e\u8457\u6539\u5584\u6e83\u75a1[\u76f8\u5bf9\u98ce\u9669(RR) 1.70;95%\u7f6e\u4fe1\u533a\u95f4(CI) 1.30-2.24]\uff0c\u800c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u538b\u529b\u6cbb\u7597\u4e0e\u5df2\u916e\u53ef\u53ef\u78b1\u7ed3\u5408\u4f7f\u7528\u66f4\u4e3a\u6709\u6548(RR 1.56; 95% CI 1.14-2.13)\u3002\u6b27\u6d32CVD\u7ba1\u7406\u6307\u5357(2018)\u63a8\u8350\u5728\u538b\u7f29\u6cbb\u7597\u7684\u8f85\u52a9\u4e0b\u4f7f\u7528\u67d1\u6a58\u9ec4\u916e\u3001\u5df2\u916e\u53ef\u53ef\u78b1\u548c\u8212\u6d1b\u5730\u7279\u6cbb\u7597VLUs(\u8bc1\u636e\u7b49\u7ea7A)[1]<\/sup>\u3002\u6b64\u5916\uff0c\u4e00\u9879\u8bc4\u4ef7\u5df2\u916e\u53ef\u53ef\u78b1\u5728\u4e2d\u56fd\u4eba\u7fa4\u4e2d\u6cbb\u7597\u9759\u8109\u6e83\u75a1\u7684\u7597\u6548\u548c\u5b89\u5168\u6027\u4e34\u5e8a\u8bd5\u9a8c\u6b63\u5728\u8fdb\u884c[36]<\/sup>\u3002<\/p>\n

2.3\u53f8\u5766\u5511\u9187<\/p>\n

\u53f8\u5766\u5511\u9187\u662f\u4e00\u79cd\u80fd\u591f\u4fc3\u8fdb\u86cb\u767d\u8d28\u5408\u6210\u7684\u7c7b\u56fa\u9187\u7c7b\u6fc0\u7d20\uff0c\u5177\u6709\u7ea4\u7ef4\u6eb6\u89e3\u7684\u4f5c\u7528\uff0c\u53ef\u4ee5\u589e\u52a0\u8840\u7ba1\u5185\u7ea4\u7ef4 \u86cb\u767d\u6d3b\u6027\u3002\u6570\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u53d1\u73b0\uff0c\u53f8\u5766\u5511\u9187\u53ef\u6539\u5584\u8102\u6027\u786c\u76ae\u75c5\u7684\u75c7\u72b6\uff0c\u4f7f\u76ae\u80a4\u539a\u5ea6\u964d\u4f4e\uff0c\u52a0\u5feb\u6e83\u75a1\u6108\u5408\u901f\u5ea6[37]<\/sup>\u3002<\/p>\n

\u201c<\/p>\n

3. \u5176\u4ed6\u836f\u7269<\/p>\n

\u9664\u4e0a\u8ff0\u836f\u7269\u4ee5\u5916\uff0c\u5176\u4ed6\u836f\u7269\u6cbb\u7597[3]<\/sup>\u5982\uff1a\u2460\u5eb7\u529b\u9f99\uff08\u4fc3\u86cb\u767d\u5408\u6210\u7c7b\u56fa\u9187\uff09\u53ef\u901a\u8fc7\u964d\u89e3\u5fae\u5faa\u73af\u4e2d\u7684\u7ea4\u7ef4\u86cb\u767d\u6539\u5584\u76ae\u80a4\u53ca\u76ae\u4e0b\u8425\u517b\uff0c\u4f7f\u8102\u6027\u786c\u76ae\u75c5\u60a3\u8005\u83b7\u76ca\uff1b\u2461\u524d\u5217\u817a\u7d20E1\uff08PGE1\uff09\u53ef\u964d\u4f4e\u76ae\u80a4\u75c5\u53d8\u7684\u708e\u6027\u53cd\u5e94\uff0c\u6291\u5236\u8840\u5c0f\u677f\u805a\u96c6\u53ca\u6539\u5584\u80a2\u4f53\u5faa\u73af\u529f\u80fd\u3002\u5bf9\u6de4\u6ede\u6027\u76ae\u708e\u3001\u8102\u6ea2\u6027\u76ae\u708e\u548c\u9759\u8109\u6027\u6e83\u75a1\u5747\u5177\u6709\u6cbb\u7597\u4f5c\u7528\uff1b\u2462\u975e\u753e\u4f53\u6297\u708e\u836f\u7269\u5bf9\u4e8e\u8102\u6ea2\u6027\u76ae\u708e\u7684\u590d\u53d1\u548c\u6d3b\u52a8\u671f\u5177\u6709\u826f\u597d\u7684\u6297\u708e\u3001\u6d88\u80bf\u548c\u6b62\u75db\u4f5c\u7528\uff0c\u5747\u53ef\u8f85\u52a9\u6cbb\u7597CVD\u5f15\u8d77\u7684\u7cfb\u5217\u4f53\u5f81\u548c\u75c7\u72b6\u3002<\/p>\n

\u201c<\/p>\n

4. \u6162\u6027\u9759\u8109\u75be\u75c5\u836f\u7269\u6cbb\u7597\u8fdb\u5c55<\/p>\n

\u836f\u7269\u6cbb\u7597\u73b0\u5df2\u6210\u4e3aCVD\u60a3\u8005\u7684\u6709\u6548\u6cbb\u7597\u65b9\u5f0f\u3002\u6709\u6548\u6539\u5584\u6162\u6027\u9759\u8109\u75be\u75c5\u7684\u75c7\u72b6\u5e76\u4e14\u5c3d\u91cf\u907f\u514d\u4e0d\u826f\u53cd\u5e94\u7684\u53d1\u751f\u662f\u836f\u7269\u6cbb\u7597\u7684\u9996\u8981\u76ee\u6807\u3002\u5728\u4e0a\u8ff0\u836f\u7269\u4e2d\uff0c\u7279\u522b\u662fMPFF\u5df2\u88ab\u5e7f\u6cdb\u7814\u7a76\u8bc1\u5b9e\u53ef\u6709\u6548\u51cf\u8f7bCVD\u7684\u4e3b\u8981\u75c7\u72b6\u548c\u4f53\u5f81\uff0c\u5e76\u6539\u5584\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u3002\u4f46\u4e34\u5e8a\u5b9e\u9645\u5e94\u7528\u65f6\uff0c\u836f\u7269\u6cbb\u7597\u7684\u6548\u679c\u53d7\u5230\u591a\u79cd\u56e0\u7d20\u7684\u5f71\u54cd\uff0c\u5982\u60a3\u8005\u7684\u75c5\u60c5\u3001\u836f\u7269\u7684\u79cd\u7c7b\u548c\u5242\u91cf\u3001\u6cbb\u7597\u65f6\u95f4\u7b49\u3002\u56e0\u6b64\uff0c\u9700\u8981\u6839\u636e\u60a3\u8005\u7684\u5177\u4f53\u60c5\u51b5\u8fdb\u884c\u4e2a\u4f53\u5316\u6cbb\u7597\u3002\u540c\u65f6\uff0c\u4e5f\u9700\u8981\u52a0\u5f3a\u60a3\u8005\u7684\u6559\u80b2\u548c\u7ba1\u7406\uff0c\u63d0\u9ad8\u60a3\u8005\u7684\u4f9d\u4ece\u6027\u548c\u81ea\u6211\u7ba1\u7406\u7684\u80fd\u529b\u3002<\/p>\n

\u7efc\u4e0a\u6240\u8ff0\uff0c\u6162\u6027\u9759\u8109\u75be\u75c5\u7684\u836f\u7269\u6cbb\u7597\u7814\u7a76\u5df2\u7ecf\u53d6\u5f97\u4e86\u4e00\u5b9a\u7684\u8fdb\u5c55\uff0c\u4f46\u4ecd\u5b58\u5728\u7597\u6548\u5c40\u9650\u6027\u548c\u526f\u4f5c\u7528\u7b49\u95ee\u9898\u3002\u672a\u6765\u9700\u8981\u8fdb\u4e00\u6b65\u63a2\u7d22\u65b0\u7684\u836f\u7269\u4f5c\u7528\u673a\u5236\u548c\u4f5c\u7528\u9776\u70b9\uff0c\u540c\u65f6\u4e5f\u9700\u8981\u52a0\u5f3a\u4e34\u5e8a\u8bd5\u9a8c\u548c\u5b9e\u9645\u5e94\u7528\u7684\u7814\u7a76\uff0c\u4ee5\u4fbf\u4e3a\u60a3\u8005\u63d0\u4f9b\u66f4\u591a\u7684\u6cbb\u7597\u9009\u62e9\u548c\u66f4\u597d\u7684\u6cbb\u7597\u6548\u679c\u3002<\/p>\n

\u4e13\u5bb6\u4ecb\u7ecd<\/p>\n

\u5218\u65b0\u519c \u6559\u6388<\/p>\n

\u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5929\u575b\u533b\u9662<\/p>\n

\u5916\u79d1\u5b66\u535a\u58eb\u3001\u4e34\u5e8a\u533b\u5b66\u535a\u58eb\u540e\uff0c\u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5929\u575b\u533b\u9662\u8840\u7ba1\u5916\u79d1,\u4e3b\u6cbb\u533b\u5e08\uff0c\u4e2d\u56fd\u63f4\u975e\u533b\u751f\uff08\u4e2d\u56fd\u7b2c29\u6279\u63f4\u51e0\u5185\u4e9a\u533b\u7597\u961f\uff09\u3002\u5148\u540e\u5e08\u4ece\u5317\u4eac\u534f\u548c\u533b\u9662\u5218\u660c\u4f1f\u6559\u6388\u548c\u9996\u90fd\u533b\u79d1\u5927\u5b66\u9644\u5c5e\u5317\u4eac\u5929\u575b\u533b\u9662\u6c88\u6668\u9633\u6559\u6388\u3002<\/p>\n

\u4e3b\u8981\u4ece\u4e8b\u4e3b\u52a8\u8109\u5939\u5c42\u3001\u8179\u4e3b\u52a8\u8109\u7624\u3001\u4e0b\u80a2\u52a8\u8109\u7ca5\u6837\u786c\u5316\u95ed\u585e\u75c7\u3001\u5927\u9690\u9759\u8109\u66f2\u5f20\u4e0e\u4e0b\u80a2\u6df1\u9759\u8109\u8840\u6813\u7b49\u5916\u5468\u8840\u7ba1\u75be\u75c5\u7684\u57fa\u7840\u4e0e\u4e34\u5e8a\u7814\u7a76\uff0c\u5c24\u5176\u64c5\u957f\u9888\u52a8\u8109\u72ed\u7a84\u95ed\u585e\u3001\u690e\u52a8\u8109\u72ed\u7a84\u95ed\u585e\u3001\u9501\u9aa8\u4e0b\u52a8\u8109\u72ed\u7a84\u95ed\u585e\u7b49\u5f13\u4e0a\u52a8\u8109\u75be\u75c5\u7684\u5f00\u653e\u4e0e\u5fae\u521b\u624b\u672f\u6cbb\u7597\u3002\u4e3b\u6301\u6216\u53c2\u4e0e\u56fd\u5bb6\u81ea\u7136\u79d1\u5b66\u57fa\u91d1\u9879\u76ee2\u9879\u3001\u5317\u4eac\u5e02\u79d1\u6280\u653b\u5173\u8ba1\u5212\u9879\u76ee1\u9879\u3001\u56fd\u5bb6\u7ea7\u7ee7\u7eed\u6559\u80b2\u9879\u76ee1\u9879\uff0c\u5df2\u516c\u5f00\u53d1\u8868\u56fd\u5185\u5916\u6838\u5fc3\u671f\u520a\u8bba\u658730\u4f59\u7bc7\uff0c\u6388\u6743\u56fd\u5bb6\u4e13\u522910\u4f59\u9879\uff0c\u4e3b\u7f16\u8457\u4f5c2\u90e8\u3002<\/p>\n

\u53c2\u8003\u6587\u732e<\/p>\n

[1]Nicolaides A, Kakkos S, Baekgaard N, et al. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Part I. Int Angiol. 2018 Jun;37(3):181-254. doi: 10.23736\/S0392-9590.18.03999-8. PMID: 29871479.<\/p>\n

[2]\u4e2d\u534e\u533b\u5b66\u4f1a\u5916\u79d1\u5b66\u5206\u4f1a\u8840\u7ba1\u5916\u79d1\u5b66\u7ec4, \u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u8840\u7ba1\u5916\u79d1\u533b\u5e08\u5206\u4f1a, \u4e2d\u56fd\u533b\u7597\u4fdd\u5065\u56fd\u9645\u4ea4\u6d41\u4fc3\u8fdb\u4f1a\u8840\u7ba1\u5916\u79d1\u5206\u4f1a, \u7b49.  \u4e2d\u56fd\u6162\u6027\u9759\u8109\u75be\u75c5\u8bca\u65ad\u4e0e\u6cbb\u7597\u6307\u5357 [J] . \u4e2d\u534e\u533b\u5b66\u6742\u5fd7,2019,99 (39): 3047-3061. DOI: 10.3760\/cma.j.issn.0376-2491.2019.39.003<\/p>\n

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