迷納斯萬能膠水靜脈閉合手術 下肢靜脈曲張治療新里程碑
2022-11-17 記者 蘇旋/台南報導
現代人大多數因工作關係都需久站、久坐及肥胖、懷孕因而導致很多人出現有下肢靜脈曲張的問題受此疾所苦，台南市安南醫院通過迷納斯萬能膠水靜脈閉合創新手術，為飽受下肢靜脈曲張疾病所苦的患者帶來福音，找回雙腿的健康與活力。
安南醫院陳偉華副院長
陳偉華副院長表示，慢性下肢回流疾病，最常見的病因便是俗稱”浮腳筋”的下肢靜脈曲張，人口當中50~80%患有此疾，10~30%長期忍受症狀，1-5%須更積極的手術介入與治療。女性、久坐久站、肥胖、懷孕以及抽菸…等為好發因子，下肢靜脈曲張起因於表淺靜脈壁長期承受靜脈壓又沒有緻密的肌肉或骨骼可環繞保護，遂逐漸鬆開，使內建之靜脈瓣因鬆弛而閉合不良，進而使小腿肌肉已擠壓回送心臟之靜脈血液又從關不緊的靜脈瓣逆流回來，更進一步撐開表淺靜脈，惡化病灶。此疾可依嚴重度區分為六級，第一級為常見之皮下”蜘蛛絲”，即末梢靜脈曲張，第二級大隱靜脈直徑大於3mm，有時腿上已可看出”浮腳筋”，第三級為水腫、大小腿、痠麻抽筋，第四級則皮膚顏色暗沉或轉而發黑，第五級則有已癒合的慢性潰瘍，第六級是無法癒合的慢性潰瘍，且靜脈曲張可能共伴有靜脈栓塞或靜脈壓迫等疾病須妥善的診斷與治療。榮獲2022年國家品質標章肯定的安南醫院心臟血管外科團隊，於治療下肢靜脈疾病擁有豐富的臨床經驗，整合併運用近年慢性靜脈疾病創新治療技術、器械、藥物…等，為飽受此疾所苦的患者帶來福音。
改良自工業用氰基丙烯酸酯膠粘劑(Cyanoacrylate Adhesives)的迷納斯萬能膠水，可運用於人體並在超音波導引下，以微創手術方式，利用導管順著靜脈傳送至靜脈曲張病灶處，於超音波監控下逐段施打膠水以黏合病灶，使靜脈血液不再流入此處並藉由綿密的靜脈互聯網路噴配到其他健康的下肢靜脈後向右心回流，如此腿部鬱積之靜脈血液便能有效回流，進而改善症狀與治療疾病，此術之特色在於萬能膠黏合靜脈分肢較為緊實，術後無需穿著彈性襪且治癒率高達九成以上，10年內再復發率小於10%，惟須留意靜脈膠水不甚流入深部靜脈造成靜脈栓塞、膠水過敏或膠水鬱積形成皮下硬塊…等副作用。
在陳偉華副院長帶領下，心臟血管外科團隊於於近三年間，共完成了107例迷納斯萬能膠水靜脈閉合手術，面對患者與病灶的多樣性，依然達成術後100%成功率且有效緩解症狀、降低併發症與副作用。因為對膠水產生局部過敏反應患者有三位，經過藥物治療，都於兩週內痊癒，沒有任何接受萬能膠水患者發生全身性過敏現象，因此於東方人使用，萬能膠水也相當安全。
陳偉華副院長強調，有別於傳統靜脈曲張手術用來改善病患小腿青筋浮腫的外觀，在這百位接受萬能膠水治療的患者裡面，有18位合併了大範圍靜脈潰瘍，經過膠水治療，今年9月以前接受手術的患者，已經痊癒，而10月以後有靜脈潰瘍的3位患者，潰瘍大小也明顯進步，可以預期2-3個月內也會癒合，因此萬能膠水不是只能醫美，更能治醜，也大大改變了病患對靜脈曲張手術的刻板印象。靜脈曲張是可以妥善預防、診斷與治療的疾病，隨著診斷治療的觀念與工具的進步，以及臨床經驗的累積，團隊運用迷納斯萬能膠水靜脈閉合微創手術，挑戰各式困難病灶併已得到初步成效，在社會各界、病友與家屬信賴與支持下，一起來克服各式慢性靜脈疾病，找回雙腿的健康與活力。
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