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[慢性静脉溃疡患者自我应用加压绷带的质量:一项前瞻性临床研究的结果]

[Quality of self-applied compression bandages in patients with chronic venous ulcers : Results of a prospective clinical study].

作者信息

Stoffels-Weindorf M, Stoffels I, Jockenhöfer F, Dissemond J

机构信息

Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.

出版信息

Hautarzt. 2018 Apr;69(4):306-312. doi: 10.1007/s00105-017-4086-1.

DOI:10.1007/s00105-017-4086-1
PMID:29184985
Abstract

BACKGROUND

For effective compression therapy in patients with venous leg ulcers, sufficient pressure is essential. In everyday life, it is often the patients themselves who apply the compression bandages. Many of these patients have restriction in their movement and had been rarely trained adequately. Hence, there was the question of how efficient are the autonomously applied compression bandages of those patients.

PATIENTS AND METHODS

In all, 100 consecutive patients with venous leg ulcer were asked to apply compression bandages on their own leg. We documented both the achieved compression and formal criteria of correct performance.

RESULTS

A total of 59 women and 41 men with an average age of 70.3 years were included in the study. Overall 43 patients were not able to apply a compression bandage because of physical limitations. The measured pressure values in the remaining 57 patients ranged between 6 and 93 mm Hg (mean 28.3 mm Hg). Eleven patients reached the prescribed effective compression pressure. Of these, formal errors were found in 6 patients, so that only 5 patients had correctly applied the compression bandages.

CONCLUSION

Our data show that most patients with venous leg ulcers are not able to apply effective compression therapy with short-stretch bandages to themselves. Multilayer systems, adaptive compression bandages, and ulcer stocking systems today are possibly easier and more effective therapy options. Alternatively short-stretch bandages could be applied by trained persons but only under the control with pressure measuring probes.

摘要

背景

对于下肢静脉性溃疡患者进行有效的压迫治疗,足够的压力至关重要。在日常生活中,通常是患者自己应用压迫绷带。这些患者中的许多人行动受限,且很少接受充分的训练。因此,存在这些患者自行应用的压迫绷带效果如何的问题。

患者与方法

总共100例连续的下肢静脉性溃疡患者被要求自行在其腿部应用压迫绷带。我们记录了所达到的压力以及正确操作的形式标准。

结果

研究纳入了59名女性和41名男性,平均年龄70.3岁。总体而言,43例患者由于身体限制无法应用压迫绷带。其余57例患者测量的压力值在6至93毫米汞柱之间(平均28.3毫米汞柱)。11例患者达到规定的有效压迫压力。其中,6例患者存在形式上的错误,因此只有5例患者正确应用了压迫绷带。

结论

我们的数据表明,大多数下肢静脉性溃疡患者无法自行用短拉伸绷带进行有效的压迫治疗。多层系统、自适应压迫绷带和溃疡袜系统目前可能是更简便且更有效的治疗选择。或者,短拉伸绷带可由经过训练的人员应用,但只能在压力测量探头的监测下进行。

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本文引用的文献

1
[Compression therapy of venous leg ulcers in the decongestion phase].[静脉性腿部溃疡充血期的加压治疗]
Med Klin Intensivmed Notfmed. 2018 Oct;113(7):552-559. doi: 10.1007/s00063-016-0254-9. Epub 2017 Jan 11.
2
Kompressionstherapie - Versorgungspraxis: Informationsstand von Patienten mit Ulcus cruris venosum.压迫疗法 - 治疗实践:下肢静脉性溃疡患者的信息状况
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Kompressionstherapie bei Patienten mit Ulcus cruris venosum.下肢静脉性溃疡患者的压迫治疗
J Dtsch Dermatol Ges. 2016 Nov;14(11):1073-1089. doi: 10.1111/ddg.13091_g.
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Ulcus cruris durch Kompressionsstrümpfe als Resultat guter Compliance aber schlechter Adhärenz.
J Dtsch Dermatol Ges. 2016 Sep;14(9):946-7. doi: 10.1111/ddg.13008_g.
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[Prophylaxis of Recurrent Venous Leg Ulcer].[下肢静脉性溃疡复发的预防]
Zentralbl Chir. 2017 Jun;142(3):306-311. doi: 10.1055/s-0042-109977. Epub 2016 Aug 8.
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[Compression therapy in leg ulcers].[腿部溃疡的压迫治疗]
Hautarzt. 2016 Apr;67(4):311-23; quiz 324-5. doi: 10.1007/s00105-016-3765-7.
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[Definitions for wound treatment].[伤口治疗的定义]
Hautarzt. 2016 Mar;67(3):265-6. doi: 10.1007/s00105-016-3761-y.
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Comparison of 4-Layer Bandages and an Adaptive Compression Therapy Device on Intended Pressure Delivery.4层绷带与自适应加压治疗设备在预期压力输送方面的比较。
J Wound Ostomy Continence Nurs. 2015 Sep-Oct;42(5):468-73. doi: 10.1097/WON.0000000000000157.
9
Adjustable Velcro Compression Devices are More Effective than Inelastic Bandages in Reducing Venous Edema in the Initial Treatment Phase: A Randomized Controlled Trial.在初始治疗阶段,可调节的尼龙搭扣加压装置在减轻静脉水肿方面比无弹性绷带更有效:一项随机对照试验。
Eur J Vasc Endovasc Surg. 2015 Sep;50(3):368-74. doi: 10.1016/j.ejvs.2015.05.014. Epub 2015 Jul 6.
10
Donning devices (foot slips and frames) enable elderly people with severe chronic venous insufficiency to put on compression stockings.穿戴装置(脚套和框架)能帮助患有严重慢性静脉功能不全的老年人穿上压力袜。
Eur J Vasc Endovasc Surg. 2015 Feb;49(2):221-9. doi: 10.1016/j.ejvs.2014.11.005. Epub 2015 Jan 8.