目的：探讨超声引导泡沫硬化剂联合腔内激光治疗对糖尿病合并大隐静脉曲张患者凝血功能、炎性因子的影响，分析其可能作用机制。方法：选择2014年5月至2016年4月收治的糖尿病合并大隐静脉曲张患者110例为研究对象，采用随机数字表法分为观察组和对照组各55例，对照组使用单纯激光治疗，观察组接受超声引导泡沫硬化剂联合腔内激光治疗，比较两组患者临床疗效、凝血功能、炎性因子、并发症等指标。结果：观察组有效率94.55%明显高于对照组81.82%（χ²=4.274，P<0.05）；术后1周，纤维蛋白原（FIB）、纤溶酶原激活物抑制剂（PAI-1）含量明显低于对照组，纤溶酶原激活剂（t-PA）含量明显高于对照组（t=2.155，9.341，6.944，P<0.05，P<0.01）；血清白细胞介素-2（IL-2）含量明显低于对照组，白细胞介素-10（IL-10）含量明显高于对照组（t=5.618，6.511，P<0.05）；皮肤灼伤等并发症9.09%明显低于对照组25.45%（χ²=5.153，P<0.05）。结论：超声引导泡沫硬化剂联合腔内激光治疗有助于提高糖尿病合并大隐静脉曲张患者临床疗效，降低术后并发症，可能与改善血液高凝状态、激活纤溶系统、抑制炎症反应等因素有关。

[1] 李文渊.腔内激光闭合术联合高位结扎术治疗糖尿病患者大隐静脉曲张[J].中国基层医药,2016,23(3):438-441.
[2] CAIROLS M. Commentary on predictors for recanalization of the great saphenous vein in RCTs 1 year after endovenous thermal ablation':The dark side of systematic reviews[J].Eur J Vasc Endovasc Surg,2016,52(2):242-242.
[3] 孙爱军,田鹏. 聚桂醇联合手术及腔内激光治疗下肢静脉曲张的临床观察[J].中国药物警戒,2013,10(9):518-520.
[4] WOZNIAK W,MLOSEK R K,CIOSTEK P. Complications and failure of endovenous laser ablation and radiofrequency ablation procedures in patients with lower extremity varicose veins in a 5-year follow-up[J].Vasc Endovascular Surg,2016,50(7):475-483.
[5] 滕厚军,王守习.腔内激光联合泡沫硬化剂治疗大隐静脉曲张的安全性研究[J].中华普通外科学文献:电子版,2016,10(6):449-450.
[6] BAESHKO A,SHESTAK N,KORYTKO S. Results of ultrasound-guided foam sclerotherapy of the great saphenous vein with new parameters of the technique[J].Vasc Endovascular Surg,2016,50(8):528-533.
[7] KORAMAZ I,EI KILIC H,GOKALP F,et al. Ablation of the great saphenous vein with nontumescent n-butyl cyanoacrylate versus endovenous laser therapy[J].J Vasc Surg Venous Lymphat Discord,2017,5(2):210-215.
[8] 张雅丽,张学志,孙奇,等.腔内激光与腔内激光联合泡沫硬化剂治疗静脉曲张的研究[J].现代中西医结合杂志,2015,(21):2322-2234.
[9] 陈兆雷,张喜成,马兵兵,等. 腔内激光闭合联合泡沫硬化剂注射治疗下肢浅静脉曲张[J].中国普通外科杂志,2012,21(6):769-770.
[10] YIN H,HE H,WANG M,et al. Prospective randomized study of ultrasound-guided foam sclerotherapy combined with great saphenous vein high ligation in the treatment of severe lower extremity varicosis[J].Ann Vasc Surg,2017,39:256-263.
[11] VENERMO M,SAARINEN J,ESKELINEN E,et al. Randomized clinical trial comparing surgery,endovenous laser ablation and ultrasound-guided foam sclerotherapy for the treatment of great saphenous varicose veins[J].Br J Surg,2016,103(11):1438-1444.
[12] MISHRA M K,SONI R K,MOHIL R S,et al. Comparative study of outcome of duplex ultrasound-guided,catheter-directed foam sclerotherapy and radio-frequency ablation in the management of great saphenous varicose veins[J].Indian J Surg,2016,78(5):375-381.
[13] 陈智勇,司小毛,仇鹏,等.超声引导泡沫硬化剂注射与传统手术治疗大隐静脉曲张疗效及安全性Meta分析[J].中国血管外科杂志:电子版,2014,6(1):26-30.
[14] 张志华,王肃生,梁刚冀,等.腔内激光闭合联合泡沫硬化剂治疗下肢静脉曲张的疗效及对患者瘤坏死因子-α、白介素-6的影响[J].海南医学,2016,27(21):3502-3505.
[15] 程璐,鲁俊,王醒.脓毒症患者血清IL-6及IL-10浓度变化与预后的相关性研究[J].东南大学学报:医学版,2014,33(4):441-445