Carr Sandra C
Wisconsin Heart and Vascular Institute, Madison, Wisconsin 53711, USA.
Perspect Vasc Surg Endovasc Ther. 2008 Mar;20(1):82-5. doi: 10.1177/1531003507313218. Epub 2008 Apr 2.
Venous ulceration of the lower extremities is a common and often disabling condition. Venous ulcers are the result of a chronic inflammatory condition caused by persistent venous hypertension. Therapy is directed at counteracting the chronic inflammation in the tissues and at decreasing ambulatory venous hypertension in the area. Compression therapy helps decrease the venous hypertension and aids healing. Topical agents may be used to help decrease the bacterial load in the wound, provide a moist healing environment for dry wounds, or absorb the exudate in wounds with a lot of drainage. Pharmacological adjuncts, such as pentoxifylline or flavanoids, may help counteract the chronic inflammation in the ulcerated area. Interventions to decrease the ambulatory venous hypertension can help patients with either active or healed ulcers. Ablation of incompetent superficial truncal veins and/or perforating veins using radiofrequency ablation, endovenous laser ablation, or foam sclerotherapy can speed ulcer healing and prevent recurrence.
下肢静脉溃疡是一种常见且往往会导致残疾的病症。静脉溃疡是由持续性静脉高压引起的慢性炎症状态的结果。治疗旨在对抗组织中的慢性炎症并降低该区域的动态静脉高压。压迫疗法有助于降低静脉高压并促进愈合。局部用药可用于帮助减少伤口中的细菌负荷，为干性伤口提供湿润的愈合环境，或吸收大量渗液伤口中的渗出物。诸如己酮可可碱或类黄酮等药物辅助剂可能有助于对抗溃疡区域的慢性炎症。降低动态静脉高压的干预措施对患有活动性溃疡或已愈合溃疡的患者均有帮助。使用射频消融、静脉腔内激光消融或泡沫硬化疗法消融功能不全的浅静脉主干和/或穿通静脉可加速溃疡愈合并预防复发。
