Teive Hélio Afonso Ghizoni, Campos Ricardo William Genaro Rodrigues de, Munhoz Renato Puppi, Werneck Lineu César
Department of Internal Medicine, Neurology Service, Hospital das Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
Sao Paulo Med J. 2008 Jul;126(4):223-4. doi: 10.1590/s1516-31802008000400005.
Pressure ulcers are lesions caused by inadequate blood flow and tissue malnourishment secondary to prolonged pressure on skin, soft connective tissues, muscle and/or bones. The authors report two distinct clinical situations of severely compromised neurological patients who shared several predisposing factors for pressure ulcers, but with opposite outcomes regarding the development of pressure ulcers.
The first case was a young patient in a persistent vegetative state who developed pressure ulcers that resulted in secondary sepsis and death. The second case was a patient with a diagnosis of amyotrophic lateral sclerosis who, in spite of being bedridden for several months with severe immobility, never developed pressure ulcers. These intriguing contrary clinical situations had already been defined by Charcot in the nineteenth century, with his creation of the expression "decubitus ominosus". He indicated that patients with amyotrophic lateral sclerosis usually did not develop this form of complication, as was illustrated by the cases presented here.
压疮是由于皮肤、软结缔组织、肌肉和/或骨骼长期受压导致血流不足和组织营养不良而引起的损伤。作者报告了两名严重神经功能受损患者的两种不同临床情况，他们有几个压疮的诱发因素相同，但在压疮发生方面却有相反的结果。
第一个病例是一名处于持续植物状态的年轻患者，发生了压疮，继发败血症并死亡。第二个病例是一名诊断为肌萎缩侧索硬化症的患者，尽管因严重行动不便卧床数月，但从未发生压疮。这些引人入胜的相反临床情况早在19世纪就被夏科特定义了，他创造了“恶性褥疮”这个表述。他指出，肌萎缩侧索硬化症患者通常不会发生这种并发症，此处呈现的病例就说明了这一点。
