Stacey M C, Burnand K G, Layer G T, Pattison M
Department of Surgery, St. Thomas' Hospital, London, UK.
Br J Surg. 1990 Sep;77(9):1050-4. doi: 10.1002/bjs.1800770932.
Transcutaneous oxygen tension (Ptc,O2) was assessed as an indicator of risk of reulceration in 68 limbs with healed venous ulcers. Ptc,O2 was also used to assess two methods of ulcer prophylaxis. Measurements were made over the gaiter skin, the healed ulcer and the upper arm. The results were expressed as a ratio of the lower limb readings over those taken from the arm. Patients were randomized, after the ulcer had healed, to elastic stockings and stanozolol, or elastic stockings and surgical ligation of incompetent superficial veins. Patients who declined to participate in the study were prescribed elastic stockings only. Those limbs remaining healed at 12 months had Ptc,O2 ratios remeasured. The Ptc,O2 ratios from limbs that reulcerated were not significantly lower than those from limbs remaining healed. The Ptc,O2 ratio was significantly increased in limbs treated by stanozolol and elastic stockings (P less than 0.05) and by surgery and elastic stockings (P less than 0.05). There was no significant increase in Ptc,O2 in limbs treated by elastic stockings alone. In those treated by surgery and elastic stockings, there was a significant improvement in limbs with normal deep veins (P less than 0.01), but not in limbs with post-thrombotic changes on ascending phlebography. Although these two methods of ulcer prophylaxis improve the Ptc,O2 ratio, a high ratio has not been shown to be beneficial in preventing ulcer recurrence.
对68例已愈合静脉溃疡的肢体进行经皮氧分压（Ptc,O2）评估，作为再溃疡风险的指标。Ptc,O2还用于评估两种溃疡预防方法。测量在小腿皮肤、愈合的溃疡和上臂进行。结果以下肢读数与上臂读数的比值表示。溃疡愈合后，患者被随机分为弹力袜加司坦唑醇组，或弹力袜加结扎功能不全的浅静脉手术组。拒绝参与研究的患者仅开具弹力袜。对12个月时仍愈合的肢体重新测量Ptc,O2比值。再溃疡肢体的Ptc,O2比值并不显著低于仍愈合肢体的Ptc,O2比值。司坦唑醇加弹力袜治疗的肢体和手术加弹力袜治疗的肢体，Ptc,O2比值显著升高（P<0.05）。单纯使用弹力袜治疗的肢体，Ptc,O2无显著升高。在手术加弹力袜治疗的患者中，深静脉正常的肢体有显著改善（P<0.01），但在静脉造影显示有血栓形成后改变的肢体中则无显著改善。虽然这两种溃疡预防方法能提高Ptc,O2比值，但尚未证明高比值对预防溃疡复发有益。
