Mosti Giovanni, Cavezzi Attilio, Bastiani Luca, Partsch Hugo
Angiology Department, MD Barbantini Clinic, Via del Calcio n.2, 55100 Lucca, Italy.
Eurocenter Venalinfa, 63074 San Benedetto del Tronto (AP), Italy.
J Clin Med. 2020 Nov 19;9(11):3709. doi: 10.3390/jcm9113709.
The aim of this study was to investigate if compression therapy (CT) can be safely applied in diabetic patients with Venous Leg Ulcers (VLU), even when a moderate arterial impairment (defined by an Ankle-Brachial Pressure Index 0.5-0.8) occurs as in mixed leg ulcers (MLU).
in one of our previous publications we compared the outcomes of two groups of patients with recalcitrant leg ulcers. Seventy-one patients were affected by mixed venous and arterial impairment and 109 by isolated venous disease. Both groups were treated by tailored inelastic CT (with compression pressure <40 mm Hg in patients with MLU and >60 mm Hg in patients with VLU) and ultrasound guided foam sclerotherapy (UGFS) of the superficial incompetent veins with the reflux directed to the ulcer bed. In the present sub analysis of the same patients we compared the healing time of 107 non-diabetic patients (NDP), 69 with VLU and 38 with MLU) with the healing time of 73 diabetic patients (DP), 40 with VLU and 33 with MLU.
Twenty-five patients were lost at follow up. The results refer to 155 patients who completed the treatment protocol. In the VLU group median healing time was 25 weeks for NDP and 28 weeks in DP ( = 0.09). In the MLU group median healing time was 27 weeks for NDP and 29 weeks for DP ( = -0.19).
when providing leg ulcer treatment by means of tailored compression regimen and foam sclerotherapy for superficial venous refluxes, diabetes has only a minor or no effect on the healing time of recalcitrant VLU or MLU.
本研究的目的是调查压迫疗法(CT)是否能安全应用于患有下肢静脉溃疡(VLU)的糖尿病患者,即使在混合性下肢溃疡(MLU)中出现中度动脉损伤(由踝臂压力指数0.5 - 0.8定义)时也是如此。
在我们之前的一篇出版物中,我们比较了两组顽固性下肢溃疡患者的治疗结果。71例患者患有混合性静脉和动脉损伤,109例患有单纯性静脉疾病。两组均采用定制的非弹性压迫疗法(MLU患者的压迫压力<40 mmHg,VLU患者的压迫压力>60 mmHg)以及对反流至溃疡床的浅表功能不全静脉进行超声引导下泡沫硬化疗法(UGFS)。在对同一批患者的本次亚分析中,我们比较了107例非糖尿病患者(NDP,69例VLU患者和38例MLU患者)与73例糖尿病患者(DP,40例VLU患者和33例MLU患者)的愈合时间。
25例患者失访。结果涉及完成治疗方案的155例患者。在VLU组中,NDP的中位愈合时间为25周,DP为28周(P = 0.09)。在MLU组中,NDP的中位愈合时间为27周,DP为29周(P = -0.19)。
当通过定制的压迫方案和泡沫硬化疗法治疗浅表静脉反流性下肢溃疡时,糖尿病对顽固性VLU或MLU的愈合时间仅有轻微影响或无影响。