Capron L
Service de médecine vasculaire, hôpital Broussais, Paris.
Rev Prat. 1994 Mar 15;44(6):771-6.
Ulceration of the skin is the most severe complication of chronic venous insufficiency of the lower limbs. The ulcer reflects a profound impairment of the venous anatomy and function, often the late sequel to a deep venous thrombosis. The available surgical techniques are rarely apt to repair these lesions completely. Medical treatment is palliative, based upon the strict control of superficial venous hypertension (leg drainage and compression) and the rational use of local therapies (ulcer cleanliness, debridement and dressing). The physician must obtain the co-operation of the patient and the help of a competent nurse. Failures and recurrences are frequent. Rather than to hopeless resignation or even to abandon, such drawbacks should lead to a critical reassessment of each step in the treatment to identify imperfections, and to correct them.
皮肤溃疡是下肢慢性静脉功能不全最严重的并发症。这种溃疡反映了静脉解剖结构和功能的严重受损，通常是深静脉血栓形成的晚期后遗症。现有的手术技术很少能完全修复这些病变。医学治疗是姑息性的，基于对浅静脉高压的严格控制（腿部引流和加压）以及合理使用局部治疗方法（溃疡清洁、清创和包扎）。医生必须获得患者的配合以及专业护士的帮助。治疗失败和复发很常见。不应绝望地听之任之甚至放弃，而应针对这些不足对治疗的每一步进行批判性重新评估，以找出缺陷并加以纠正。
