Nemeth A J, Eaglstein W H, Falanga V
Department of Dermatology, University of Pittsburgh School of Medicine, Pennsylvania.
J Am Acad Dermatol. 1989 Feb;20(2 Pt 1):186-90. doi: 10.1016/s0190-9622(89)70019-0.
Few data exist on the prognosis of venous ulcers. We therefore prospectively studied 14 patients with severe venous ulcers for up to 18 months and examined various possible prognostic factors, including transcutaneous oxygen tension (TcPO2) measurements of skin next to the ulcers. The ulcers had been present for a mean duration of 15.6 months before referral to our clinic. During the study only four patients (29%) had ulcers that were healed with conservative management consisting of topical and systemic antibiotics and conventional and occlusive dressings. We observed that the number of ulcers, their duration before admission to the study, and the extent of lipodermatosclerosis were more pronounced in the unhealed group. For all patients the mean ulcer TcPO2 level (5.6 +/- 1.5 mm Hg, mean +/- standard error) was significantly reduced when compared with the control chest site (62.4 +/- 2.1 mm Hg) (p less than 0.001; paired t test). The mean ulcer TcPO2 was not significantly different between the healed (4.5 +/- 2.0 mm Hg) and unhealed groups (6.1 +/- 2.0 mm Hg). We conclude that TcPO2 levels may not be predictive of the response to therapy in venous ulcers. TcPO2 levels may be markedly reduced, but even extremely low levels are not incompatible with healing.
关于静脉性溃疡的预后，现有数据较少。因此，我们对14例患有严重静脉性溃疡的患者进行了为期18个月的前瞻性研究，并检查了各种可能的预后因素，包括溃疡旁皮肤的经皮氧分压（TcPO2）测量。这些溃疡在转诊至我们诊所之前平均已存在15.6个月。在研究期间，只有4例患者（29%）的溃疡通过局部和全身使用抗生素以及传统和封闭敷料的保守治疗得以愈合。我们观察到，未愈合组的溃疡数量、入院前的持续时间以及脂性硬皮病的程度更为明显。与对照胸部部位（62.4±2.1 mmHg）相比，所有患者的溃疡平均TcPO2水平（5.6±1.5 mmHg，平均值±标准误）显著降低（p<0.001；配对t检验）。愈合组（4.5±2.0 mmHg）和未愈合组（6.1±2.0 mmHg）之间的溃疡平均TcPO2无显著差异。我们得出结论，TcPO2水平可能无法预测静脉性溃疡对治疗的反应。TcPO2水平可能会显著降低，但即使是极低的水平也并非与愈合不相容。
