Palfreyman S J, Michaels J A
Sheffield Vascular Institute, University of Sheffield, Sheffield, UK.
Phlebology. 2009;24 Suppl 1:13-33. doi: 10.1258/phleb.2009.09s003.
Compression hosiery is widely used in the prevention and management of symptoms related to varicose veins. However, there are still gaps and questions in relation to its benefit. This review seeks to examine the current evidence regarding the effectiveness of compression hosiery in the treatment of varicose veins.
Prospective, randomized controlled trials (RCTs) evaluating compression hosiery in the treatment of varicose veins were sought. Where RCTs were unavailable other evidence was included. Studies were included if they evaluated the application of compression to patients with a diagnosis of varicose veins. Twelve electronic bibliographic databases and 18 internet-based research resources were searched. Inclusion or exclusion of trials was decided by two reviewers acting independently.
The search strategy identified 25 studies. Eleven were RCTs or systematic reviews, 12 non-randomized studies and two guidelines. No consensus was found regarding the class of compression needed for the effective management of varicose veins. Wearing compression improved symptom management, but could be confounded by the exclusion of high number of non-compliant patients within the trials. Wearing compression to slow the progression, or prevent the reoccurrence of varicose veins could not be supported by the current published evidence.
The evidence for the benefit of compression hosiery for varicose veins was equivocal. The published literature was often contradictory and had methodological flaws.
压力袜广泛用于预防和处理与静脉曲张相关的症状。然而,关于其益处仍存在差距和疑问。本综述旨在审视目前有关压力袜治疗静脉曲张有效性的证据。
寻找评估压力袜治疗静脉曲张的前瞻性随机对照试验(RCT)。若没有RCT,则纳入其他证据。如果研究评估了对诊断为静脉曲张的患者应用压力治疗,则纳入该研究。检索了12个电子文献数据库和18个基于互联网的研究资源。试验的纳入或排除由两名独立的评审员决定。
检索策略共识别出25项研究。其中11项为RCT或系统评价,12项为非随机研究,2项为指南。关于有效管理静脉曲张所需的压力等级,未达成共识。穿着压力袜可改善症状管理,但可能因试验中排除大量不依从患者而产生混淆。目前已发表的证据无法支持穿着压力袜减缓静脉曲张进展或预防其复发。
压力袜对静脉曲张有益的证据并不明确。已发表的文献往往相互矛盾,且存在方法学缺陷。