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慢性静脉功能不全患者下肢溃疡的管理:罗马尼亚布加勒斯特皮肤科诊所的经验。

Management of leg ulcers in patients with chronic venous insufficiency: the experience of a Dermatology Clinic in Bucharest, Romania.

机构信息

2nd Clinic of Dermatology, Colentina Clinical Hospital, Bucharest, Romania.

出版信息

Dermatol Ther. 2012 Jul-Aug;25(4):304-13. doi: 10.1111/j.1529-8019.2012.01513.x.

Abstract

Venous ulcers are the most severe skin manifestation of chronic venous insufficiency. Treatment is complex and it is performed according to the stage of the disease. It includes changes of lifestyle, compressive therapy, phlebotropic medication, topical therapy of the ulcer, antibiotic therapy (topical and systemic), sclerotherapy, and surgical treatment. Patients with venous leg ulcers that attend the Second Dermatology Clinic of Colentina Clinical Hospital, are treated both as inpatients and as outpatients. They benefit from topical treatment and bandaging performed by specialized medical personnel in separate treatment room with strictly monitored conditions of asepsis and antisepsis. A follow-up study of these patients was made from January 1, 2009 to December 31, 2011. The average age of patients was 65.9 years (± 14.2), most of them being in the eight decade of life (31.9%). In almost half of the cases (44.2%), the patients spent more than 1 week in the hospital. Bacteriological investigations from the ulcers were performed in 55.1% of patients and the most frequent infectious agents were found to be Staphylococcus aureus (26.3%) and Enterobacter spp. (17.2%). Treatment of leg ulcer patients proves to be a long and complex one, a systematic and organized approach being needed in order to obtain healing of the wound.

摘要

静脉溃疡是慢性静脉功能不全最严重的皮肤表现。治疗方法复杂,根据疾病的阶段进行治疗。它包括生活方式的改变、压迫治疗、静脉活性药物治疗、溃疡的局部治疗、抗生素治疗(局部和全身)、硬化疗法和手术治疗。在科伦蒂娜临床医院第二皮肤科就诊的下肢静脉溃疡患者,既可以住院治疗,也可以门诊治疗。他们受益于专门医务人员在严格无菌和消毒条件下的单独治疗室进行的局部治疗和包扎。对这些患者进行了从 2009 年 1 月 1 日至 2011 年 12 月 31 日的随访研究。患者的平均年龄为 65.9 岁(±14.2),其中大多数在 80 岁以上(31.9%)。在近一半的病例(44.2%)中,患者在医院的住院时间超过 1 周。对溃疡进行了细菌学调查,发现 55.1%的患者存在感染,最常见的感染因子是金黄色葡萄球菌(26.3%)和肠杆菌属(17.2%)。下肢溃疡患者的治疗是一个长期而复杂的过程,需要系统和有组织的方法来实现伤口愈合。

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