Vogeley C L, Coeling H
Graduate Nursing of the Adult Program, Kent State University College of Nursing, Kent, Ohio, USA.
J Vasc Nurs. 2000 Dec;18(4):123-7. doi: 10.1067/mvn.2000.109982.
Venous ulcers may result from damage to the lining of the veins after an occurrence of deep vein thrombosis (DVT). As the pressure in the damaged venous system remains pathologically high, a result of DVT, swelling develops, hemosiderin staining develops around the ankle area, and varicosities often develop. These symptoms are part of the postphlebitic syndrome and are a precursor to formation of the chronic venous ulcer. The mainstay of treatment or prevention for venous ulcers remains compression therapy. In spite of the evidence that compression is necessary to reduce edema and allow the ulcer to heal, many patients still are not using compression after DVT to prevent ulcer formation. This article describes the prevalence, cost, etiology, and pathophysiology of postphlebitic syndrome and presents the nursing intervention of compression therapy as an ulcer prevention strategy for the patient with DVT. A variety of compression strategies are discussed. A case study of a patient in need of compression therapy is presented.
静脉溃疡可能源于深静脉血栓形成(DVT)后静脉内膜受损。由于受损静脉系统中的压力因DVT而病理性持续升高,会出现肿胀,踝关节周围会出现含铁血黄素沉着,且常常出现静脉曲张。这些症状是静脉炎后综合征的一部分,是慢性静脉溃疡形成的先兆。静脉溃疡治疗或预防的主要方法仍然是压迫疗法。尽管有证据表明压迫对于减轻水肿和促进溃疡愈合是必要的,但许多患者在发生DVT后仍未采用压迫措施来预防溃疡形成。本文描述了静脉炎后综合征的患病率、成本、病因及病理生理学,并介绍了作为DVT患者溃疡预防策略的压迫疗法的护理干预措施。文中讨论了多种压迫策略。还介绍了一名需要压迫疗法的患者的案例研究。