「膠水」治療靜脈曲張?

信報 2015-05-07 黃婆婆自八十大壽不久,逐漸感到雙腿出現異樣︰雙足常感痕癢,一旦用力搔抓,皮膚被抓損,痕癢又再加劇,渾身不自在。這樣的情況維持差不多十年,子女發現年邁母親受此問題困擾愈來愈明顯,終勸服她接受醫生檢查,結果發現原來已患上嚴重靜脈曲張問題。 現時在處理不同類型及程度的下肢靜脈曲張個案時,外科醫生的治療方案選擇亦變得多元化,各類微創手術包括靜脈腔內消融術、射頻、激光手術等,可因應病情的需要而使用。然而,考慮到黃婆婆年事已高,加上身體狀況並不理想,醫生經考慮後,建議為她安排另一種治療新方案︰醫用結合劑作注射治療。 此種技術俗稱「黏膠水」,將有問題的靜脈黏緊封閉。手術只須輕微的局部麻醉,透過一個微小創口,在超聲波的監測下,將導管放進適當的位置,再注入結合劑。以黃婆婆為例,她在接受治療後不久,過往痕癢不適的感覺漸漸減退,睡眠及生活質素亦因此改善。整體而言,這是一類較新的靜脈曲張治療,短期效果理想,但由於技術應用時間較短,暫仍缺乏對其長遠成效/可能出現之副作用的研究。公仔箱論壇)` 現時治療靜脈曲張,無論是傳統的外科切割手術、微創的射頻或激光消融術,以至最新近的黏合劑注射等,其原理都是用不同方法把有問題的靜脈清除或堵塞。 被清除或堵塞的靜脈,都是已失去正常功能,甚至是有害的靜脈。即使留在身體,對血液循環已幫不上忙,反而令功能更差。再者,下肢的靜脈血管,像一個網絡般錯綜複雜,其功能是把血液由腿部帶回心臟,但當其中一組靜脈,發生血液逆流時,血液便會過量地積聚在小腿,要靠健康的靜脈努力地把積聚的血液帶回心臟。久而久之,本來健康的靜脈,亦會因負荷過重而變壞,加入靜脈曲張的行列! 因此醫生透過超聲波,找出已損壞的靜脈血管,並透過各種方法將之清除、封閉,不但可把血液逆流消除,更可減輕其他正常靜脈負荷。 外科專科醫生謝卓華

Invited Speaker in the Multi-specialty Medical Mega Conference 2015

Topic: Screening, Diagnosis & Treatment of Abdominal Aortic Aneurysm, 25-26 April, 2015 The conference is jointly organized by 39 medical societies, and includes a full range of medical sessions, plenary conference and lunch symposium on the hottest topics that concerns our profession. Dr. Tse is the invited speaker & chairperson of the session “ Minimally …

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應否穿壓力襪?

星島日報 2015-04-09 近年壓力襪的使用漸漸普及,既有跑步及行山人士歡迎的「運動型」,亦有愛美一族使用的「瘦腿型」。 這類普及化的壓力襪,原理多源自傳統用於控制靜脈曲張的「醫用型」壓力襪。特點是使用「漸進式壓力」, 即壓力由腳跟開始向上沿小腿及大腿方向續漸遞減,在腳跟位置的壓力最大,小腿或大腿位置的壓力最輕。 此原理是仿照足部活動時,小腿肌肉的收縮及放鬆,令血液向上輸送,避免血液於小腿及足踝位置積聚,以加速下肢血液回流至心臟,減少下肢靜脈所受壓力。 一般醫用型壓力襪用於靜脈曲張及蜘蛛網狀靜脈等患者,具舒緩症狀、減慢病情惡化功效。由於這類襪的壓力較大,故應該於醫護人員指引下使用,而包裝上亦會註明該襪提供之壓力度數,以防誤用。誤用可致靜脈曲張 曾經有病人誤以為穿緊一點的襪也可有同樣功效,結果反令血液循環更差及足部發脹。因普通襪的設計,最緊的地方一般在襪的頂部,即大腿或小腿位置,這樣會令足部血液回流更困難。早前亦有報道指,長期穿設計不當的美腿壓力襪,可令人更容易出現靜脈曲張。 運動壓力襪理論上可支援及承托肌肉、減少肌肉震動而減低運動時的疲勞及勞損。至於瘦腿型壓力襪,恐怕只是推廣宣傳伎倆,現未有任何醫學數據支持,用家別抱太大期望。 外科專科醫生謝卓華

Invited Speaker for LINC Asia-Pacific in Hong Kong

Topic: Flash Presentation: Use of Thrombectomy Device + DEB in Thrombosed SFA Stent, 9–11 March, 2015 LINC Asia-Pacific is strongly committed to contribute to a systematic scientific evaluation and interdisciplinary discussion of new methods, allowing conclusions for daily interventional practice.  LINC Asia-Pacific is an interdisciplinary live course, designed to provide a global platform, permitting the …

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謝卓華醫生於Healthscope Asia探討腹主動脈瘤 (第一部份)

09/02/2015 Abdominal Aortic Aneurysm (AAA) is becoming more and more common in Hong Kong and is known as a “silent killer” due to its asymptomatic nature. The prevalence of this disease is global. U.S and U.K have seen 15,000 deaths [1] and 6,000 deaths [2] respectively caused by ruptured AAAs. In Hong Kong, more than …

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Attending the LINC 2015 conference in Germany

27–30 January, 2015 To keep update of the service we provide, our surgeon, Dr. Tse attended one of the biggest international vascular interventional conference in Jan 2015. The Leipzig Interventional Course in Germany is committed to advancing the scientific and clinical evaluation and treatment of patients with complex vascular disease through an interdisciplinary discussion of …

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Invited Speaker for the Continue Medical Education of the New Territories West Practicing Practitioners

Topic: Modern Management of Chronic Wounds & How to Heal Arterial & Venous Ulcers?, 16 Jan, 2015 The purpose of this talk is to provide physician with an overview of up-to-date management of wound care, including phases of healing and steps for addressing arterial and venous ulcers. All doctors need to manage wounds to certain …

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