Olyaie Mojtaba, Rad Fatemeh Samiee, Elahifar Mohammad-Ali, Garkaz Azadeh, Mahsa Ghasemi
Zahedan University of Medical Sciences, Zahedan, Iran.
Ostomy Wound Manage. 2013 Aug;59(8):14-20.
Ultrasound therapy can be utilized to manage chronic wounds, including venous leg ulcers (VLUs). A randomized, controlled clinical study was conducted to compare the effectiveness of standard treatment and standard treatment plus either high-frequency ultrasound (HFU) or noncontact low-frequency ultrasound (NCLFU) on VLU outcomes. Ninety (90) outpatients (47 men, 43 women, average age 38.3 [SD 11.5] years) were randomized into the standard care (n = 30), HFU (n = 30), or NCLFU group (n = 30). Standard care included multilayered compression bandaging (40 mm Hg of pressure at the ankle graduated to 17 mm Hg to 20 mm Hg below the knee), nonadherent dressing, and regular debridement. Standard care dressing changes and ultrasound therapy were provided three times per week for 3 months or until healed. HFU delivers high-intensity (0.5-1 W/cm2), high-frequency (1-3 MHz) ultrasound for 5 to 10 minutes; and NCLFU delivers low-intensity (0.1-0.8 W/cm2), low-frequency (40 kHz) ultrasound for 4-10 minutes. After 3 months, patients continued to be followed until healed. Wound size, wound pain, and lower leg edema were assessed at baseline and after 2 and 4 months. Data were analyzed using Student's t-test, ANOVA, chi-square, or Fisher's exact test. P <0.05 was considered significant. Initial wound measurements were 9.60 cm2 (SD 5.54), 9.86 cm2 (SD 3.95), and 10.01 cm2 (SD 4.58) for the standard treatment, HFU, and NCLFU groups, respectively; after 4 months, measurements were 4.28 cm2 (SD 2.80), 3.23 cm2 (SD 2.39), and 2.72 cm2 (SD 2.16), a statically significant difference (P = 0.04). All wounds were healed after an average of 8.50 (SD 2.17), 6.86 (SD 2.04), and 6.65 (SD 1.59) months in the standard treatment, HFU, and NCLFU groups, respectively (P = 0.001). Differences in the amount of edema and pain rating scores were also significant at the 4-month, follow-up visit (P <0.05). Outcomes of both methods of ultrasound therapy were better than standard care alone, and some differences between the two ultrasound therapy groups were observed, but they were not statistically significant.
超声疗法可用于处理慢性伤口，包括下肢静脉溃疡（VLUs）。一项随机对照临床研究比较了标准治疗以及标准治疗联合高频超声（HFU）或非接触低频超声（NCLFU）对下肢静脉溃疡治疗效果的差异。90名门诊患者（47名男性，43名女性，平均年龄38.3岁[标准差11.5]）被随机分为标准护理组（n = 30）、高频超声组（n = 30）或非接触低频超声组（n = 30）。标准护理包括多层加压包扎（脚踝处压力为40 mmHg，逐渐递减至膝盖以下17 mmHg至20 mmHg）、非粘性敷料以及定期清创。标准护理换药和超声治疗每周进行3次，持续3个月或直至伤口愈合。高频超声以高强度（0.5 - 1 W/cm²）、高频（1 - 3 MHz）进行5至10分钟的超声治疗；非接触低频超声以低强度（0.1 - 0.8 W/cm²）、低频（40 kHz）进行4 - 10分钟的超声治疗。3个月后，继续对患者进行随访直至伤口愈合。在基线以及2个月和4个月后评估伤口大小、伤口疼痛和小腿水肿情况。使用学生t检验、方差分析、卡方检验或费舍尔精确检验对数据进行分析。P <0.05被认为具有统计学意义。标准治疗组、高频超声组和非接触低频超声组的初始伤口测量面积分别为9.60 cm²（标准差5.54）、9.86 cm²（标准差3.95）和10.01 cm²（标准差4.58）；4个月后，测量面积分别为4.28 cm²（标准差2.80）、3.23 cm²（标准差2.39）和2.72 cm²（标准差2.16），差异具有统计学意义（P = 0.04）。标准治疗组、高频超声组和非接触低频超声组的所有伤口平均分别在8.50（标准差2.17）、6.86（标准差2.04）和6.65（标准差1.59）个月后愈合（P = 0.001）。在4个月的随访中，水肿量和疼痛评分的差异也具有统计学意义（P <0.05）。两种超声治疗方法的效果均优于单纯标准护理，并且在两个超声治疗组之间观察到了一些差异，但无统计学意义。
