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长期压迫治疗下肢动静脉混合性病因溃疡患者的临床疗效与安全性

Clinical Efficacy and Safety of Long-Term Compression in Patients with Mixed Arterial and Venous Etiology Ulcers in the Leg.

作者信息

Elhomsy Sophie, Chrusciel Jan, Sanchez Stéphane, Elhomsy Paul, Guillaumat Jérôme

机构信息

Department of Vascular Medicine, Centre Hospitalier de Troyes, Troyes, France.

Department of Public Health, Centre Hospitalier de Troyes, Troyes, France.

出版信息

Int J Angiol. 2021 Aug 31;31(1):34-39. doi: 10.1055/s-0041-1735204. eCollection 2022 Mar.

Abstract

Elastic compressions are standard treatment for leg ulcers of venous etiology. The effect of compressions on ulcers of mixed (arterial or venous) etiology, however, has rarely been studied. The objective of this study was to evaluate the variation in transcutaneous oxygen pressure (TcPO2) in patients with ulcers of mixed arterial or venous etiology treated with 1 month of compression. This prospective cohort study was conducted at a university hospital in France. Patient eligibility was for those attending a consultation of a work-up of a leg ulcer of mixed arterial-venous etiology lasting at least 4 to 6 weeks. Compressions were prescribed according to the hemodynamic status and were evaluated by the ankle-brachial index and toe-brachial index using a decision-making algorithm based on French national guidelines. Quality of life was assessed using the Short-Form 36-Item (SF-36) questionnaire. In total, 32 patients were included between September 30, 2018 and May 31, 2019. A difference was observed between TcPO2 before compression (49.3 ± 13.01 mm Hg) and after 1 month (51.2 ± 15.05 mm Hg), average change 1.9 ± 2.04 mm Hg (  = 0.025). The average ulcer size prior to compression was 49 ± 102 cm versus 37 ± 94 cm after 1 month of effective compression, corresponding to a reduction of 12 ± 8 cm (  < 0.001). There was a reduction in the bodily pain dimension of the SF-36. Compressions adapted to the hemodynamic status led to an increase in TcPO2, a reduction in wound size, and an improvement to bodily pain in patients with leg ulcers of mixed arterial-venous etiology.

摘要

弹性压迫是治疗静脉性病因腿部溃疡的标准方法。然而,压迫对混合性(动脉或静脉)病因溃疡的影响鲜有研究。本研究的目的是评估接受1个月压迫治疗的混合性动脉或静脉病因溃疡患者经皮氧分压(TcPO2)的变化。这项前瞻性队列研究在法国一家大学医院进行。纳入标准为那些因混合性动静脉病因腿部溃疡前来就诊至少4至6周的患者。根据血流动力学状况开具压迫治疗方案,并使用基于法国国家指南的决策算法通过踝臂指数和趾臂指数进行评估。使用简短36项健康调查(SF - 36)问卷评估生活质量。2018年9月30日至2019年5月31日期间共纳入32例患者。观察到压迫前的TcPO2(49.3±13.01 mmHg)与1个月后的TcPO2(51.2±15.05 mmHg)存在差异,平均变化为1.9±2.04 mmHg(P = 0.025)。压迫前溃疡平均大小为49±102 cm²,有效压迫1个月后为37±94 cm²,相当于减小了12±8 cm²(P < 0.001)。SF - 36的身体疼痛维度有所降低。根据血流动力学状况调整的压迫治疗可使混合性动静脉病因腿部溃疡患者的TcPO2升高、伤口大小减小以及身体疼痛得到改善。

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