Zhu Wei, Song Huapei
Southwest Hospital, Army Medical University, Chongqing, China.
Int J Low Extrem Wounds. 2019 Dec;18(4):389-392. doi: 10.1177/1534734619870098. Epub 2019 Aug 29.
Venous leg ulcers are a manifestation of lower extremity chronic venous disorder. Venous hypertension caused by abnormal venous blood flow is considered to be the primary mechanism of venous ulcers. The etiology of lower extremity venous ulcer is complicated, and it is difficult to be treated. At present, it has achieved a certain effect for venous leg ulcers through the combination of drugs, pressure therapy, and surgical treatment. Budd-Chiari syndrome is a rare syndrome characterized by portal hypertension and/or inferior vena cava syndrome. Treatment of Budd-Chiari syndrome includes anticoagulation, thrombolysis, angioplasty, stenting, transjugular intrahepatic portosystemic shunt, and liver transplantation. This article reports an elderly female patient with recurrent ulceration of both lower extremities that healed poorly after long-term dressing and skin grafting. During further examination, she was found to have Budd-Chiari syndrome. Through multidisciplinary treatment, which includes removing the inferior vena cava stenosis and implanting the ulcer wound, the ulcer wounds then healed.
下肢静脉溃疡是下肢慢性静脉疾病的一种表现。由异常静脉血流引起的静脉高压被认为是静脉溃疡的主要机制。下肢静脉溃疡的病因复杂，难以治疗。目前，通过药物、压力治疗和手术治疗相结合，对下肢静脉溃疡已取得一定疗效。布加综合征是一种罕见的综合征，其特征为门静脉高压和/或下腔静脉综合征。布加综合征的治疗包括抗凝、溶栓、血管成形术、支架置入、经颈静脉肝内门体分流术和肝移植。本文报道了一名老年女性患者，双下肢反复溃疡，长期换药及植皮后愈合不佳。在进一步检查中，发现她患有布加综合征。通过多学科治疗，包括解除下腔静脉狭窄并植入溃疡创面，溃疡创面随后愈合。
