Berbis P
Service de dermatologie, CHU de Marseille, hôpital Nord.
Rev Prat. 1994 Sep 1;44(13):1776-80.
The neurovascular aspects of healing failure have a common pathogenetic factor, the diminished delivery of oxygen to peripheral tissues. Recent hypotheses on the pathogenesis of ulcers via venous insufficiency underline the presence of pericapillary fibrinous sleeves which justify the use of prolonged venous compression. Encouraging preliminary results have been reported concerning the use of topic vasodilators (prostaglandin E2, ketanserin) in the treatment of leg ulcers. Diabetic neurotrophic ulcers are of multifactorial origin, with disorders of the sympathetic nervous system having a determinant role. Whatever the cause of healing failure, diagnosis and treatment should also take into account general factors, whether extrinsic, or intrinsic.
愈合失败的神经血管因素有一个共同的致病因素，即外周组织氧气输送减少。最近关于静脉功能不全导致溃疡发病机制的假说强调了毛细血管周围纤维蛋白袖套的存在，这为长期使用静脉压迫提供了依据。关于局部使用血管扩张剂（前列腺素E2、酮色林）治疗腿部溃疡，已有令人鼓舞的初步结果报道。糖尿病神经营养性溃疡起源于多因素，其中交感神经系统紊乱起决定性作用。无论愈合失败的原因是什么，诊断和治疗都应考虑一般因素，无论是外在因素还是内在因素。
