Suehiro Kotaro, Morikage Noriyasu, Harada Takasuke, Takeuchi Yuriko, Ike Soichi, Otsuka Ryo, Sakamoto Ryunosuke, Kurazumi Hiroshi, Suzuki Ryo, Hamano Kimikazu
Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Ann Vasc Dis. 2023 Sep 25;16(3):174-180. doi: 10.3400/avd.oa.22-00132.
This study aimed to clarify the features and causes of dependent edema (DE) in the legs of patients in geriatrics. We retrospectively reviewed 224 patients with DE, aged ≥65 years, who visited our clinic from April 2009-March 2022. DE was defined as bilateral leg edema in patients without known systemic edemagenic conditions, venous insufficiency confirmed by duplex venous scanning, or a cancer treatment history in the pelvic/inguinal lesions. The median patient age was 77 years (range: 65-94 years), where 74% were female. Overall, 198 patients (88%) had gait disturbances caused mainly by musculoskeletal disorders, but 58 (26%) walked without aid. Compared with patients with DE only (N=129), patients with DE and venous stasis-related skin lesions (N=95) included a larger number of those with obesity than did those with DE only (26% vs. 14%, p=0.02). The primary cause of DE in older patients was the sedentary lifestyle secondary to aging and gait disturbance, not solely because of reduced leg function. The complications of obesity are associated with increased venous stasis-related skin lesions.
本研究旨在阐明老年患者腿部依赖性水肿（DE）的特征及成因。我们回顾性分析了2009年4月至2022年3月期间来我院就诊的224例年龄≥65岁的DE患者。DE定义为无已知全身性致水肿疾病、经双功静脉扫描证实无静脉功能不全或无盆腔/腹股沟病变癌症治疗史的患者出现双侧腿部水肿。患者年龄中位数为77岁（范围：65 - 94岁），其中74%为女性。总体而言，198例患者（88%）存在主要由肌肉骨骼疾病引起的步态障碍，但58例（26%）无需辅助即可行走。与仅患有DE的患者（N = 129）相比，患有DE且伴有静脉淤滞相关皮肤病变的患者（N = 95）中肥胖患者的数量多于仅患有DE的患者（26%对14%，p = 0.02）。老年患者DE的主要原因是衰老和步态障碍导致的久坐生活方式，而非仅仅因为腿部功能减退。肥胖并发症与静脉淤滞相关皮肤病变增多有关。
