Popplewell Matthew A, Mahesh Sindoora, Nandra Sandip, Juszczak Maciej, Ashby Helen, Wall Michael L
Black Country Vascular Network, Dudley Group of Hospitals NHS Trust, Dudley, UK.
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Phlebology. 2025 Apr;40(3):161-166. doi: 10.1177/02683555241284179. Epub 2024 Sep 17.
IntroductionIndividuals with high body mass index (BMI) are more likely to have symptomatic LLVD than age matched populations with normal BMI. National priorities in venous disease set by the James Lind Alliance focus on improving access to healthcare and patient education. The aims of this study are to determine patient knowledge and potential burden of LLVD in a population of patients attending a UK, regional weight management service.MethodsA postal questionnaire containing 12 questions relating to LLVD and obesity was distributed to the active list of patients under the weight management medical service at Dudley Group of Hospitals between May 2022-23. Respondents were provided with a stamped, addressed envelope to return the questionnaire. Ethical approval was granted by the Hampshire Research & Ethics Committee.ResultsSome 367 questionnaires were distributed to patients currently enrolled in specialist weight management services. 103 complete responses were received (28%), Most patients were between 50 and 70 years of age. 25% of patients already had a formal diagnosis of LLVD, with a further 84 (82%) reported signs or symptoms which may be related to LLVD. Almost half (49/103, 48%) had concerns over their skin quality with a similar proportion (25/103, 51%) having sought medical help. The majority (71/103, 69%) were unaware of the association between obesity and LLVD. Twelve participants had education regarding simple adjuncts designed to improve symptoms and/or prevent ulceration (emollients, dressings, stockings, or leg elevation). Four participants had previously undergone treatment for varicose veins.ConclusionIn a population of patients accessing weight management services, we have demonstrated that a quarter of patients have already received a diagnosis of LLVD, however there is for a greater undiagnosed burden of LLVD in part due to lack of patient and possibly clinician awareness.
引言
与体重指数（BMI）正常的年龄匹配人群相比，BMI高的个体更有可能出现有症状的下肢静脉疾病（LLVD）。詹姆斯·林德联盟设定的静脉疾病国家优先事项侧重于改善医疗服务的可及性和患者教育。本研究的目的是确定在英国一家地区体重管理服务机构就诊的患者群体中，患者对LLVD的了解情况以及LLVD的潜在负担。
方法
2022年5月至2023年期间，向达德利集团医院体重管理医疗服务下的活跃患者名单发放了一份包含12个与LLVD和肥胖相关问题的邮政问卷。为受访者提供了一个贴有邮票、写好地址的信封以便返还问卷。该研究获得了汉普郡研究与伦理委员会的伦理批准。
结果
共向目前参加专科体重管理服务的患者发放了约367份问卷。收到了103份完整回复（28%），大多数患者年龄在50至70岁之间。25%的患者已经被正式诊断为LLVD，另有84名（82%）报告了可能与LLVD相关的体征或症状。几乎一半（49/103，48%）的患者担心自己的皮肤质量，有类似比例（25/103，51%）的患者寻求过医疗帮助。大多数（71/103，69%）患者不知道肥胖与LLVD之间的关联。12名参与者接受了关于旨在改善症状和/或预防溃疡的简单辅助措施（润肤剂、敷料、弹力袜或抬高腿部）的教育。4名参与者此前接受过静脉曲张治疗。
结论
在接受体重管理服务的患者群体中，我们发现四分之一的患者已经被诊断为LLVD，然而，LLVD未被诊断的负担更大，部分原因是患者以及可能还有临床医生缺乏认识。
