Sugrue M E, Carolan J, Leen E J, Feeley T M, Moore D J, Shanik G D
Department of Vascular Surgery, St. James's Hospital, Dublin, Ireland.
Ann Vasc Surg. 1990 Mar;4(2):179-81. doi: 10.1007/BF02001375.
Management of intractable venous ulceration remains an unrewarding task which is increasingly delegated to the realm of the vascular surgeon. The purpose of this pilot study was to assess the ulcer-healing effects of the newest form of biostimulation--the low power laser. Twelve patients with chronic venous ulcers unresponsive to conservative measures were treated with infrared laser irradiation for twelve weeks. Two ulcers healed completely and there was a 27% (p less than 0.01) reduction in size of the remaining ulcers. Treatment resulted in a 44% (p less than 0.01) increase in ulcer floor area occupied by healthy granulation tissue. The most dramatic effect of laser treatment was the reduction in ulcer pain, from 7.5 to 3.5 (linear analogue scale) (p less than 0.001). Laser irradiation had no effect on TcPO2, number of skin capillaries or pericapillary fibrin deposition in the lipodermatosclerotic area around the ulcer. The results of this pilot study are encouraging and a carefully controlled randomized study is indicated to compare low power laser irradiation to conventional treatment in the management of venous ulcers.
顽固性静脉溃疡的治疗仍然是一项收效甚微的任务，越来越多地被交给血管外科医生来处理。这项初步研究的目的是评估最新形式的生物刺激——低功率激光——对溃疡愈合的效果。12例对保守治疗无反应的慢性静脉溃疡患者接受了红外激光照射，为期12周。2处溃疡完全愈合，其余溃疡面积缩小了27%（p<0.01）。治疗使健康肉芽组织占据的溃疡底部面积增加了44%（p<0.01）。激光治疗最显著的效果是溃疡疼痛减轻，从7.5降至3.5（线性模拟量表）（p<0.001）。激光照射对溃疡周围脂膜皮肤硬化区域的经皮氧分压、皮肤毛细血管数量或毛细血管周围纤维蛋白沉积没有影响。这项初步研究的结果令人鼓舞，因此有必要进行一项严格对照的随机研究，以比较低功率激光照射与传统治疗方法在静脉溃疡治疗中的效果。
