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[营养性溃疡迁延不愈的联合治疗]

[Combined therapy of trophic ulcers with protracted healing].

作者信息

Babadzhanov B R, Sultanov I A

出版信息

Khirurgiia (Mosk). 1998(4):42-5.

PMID:9613063
Abstract

The results of treatment of 126 patients with trophic ulcers of the low extremities were analyzed. Trophic ulcers in 74 patients (58.7%) appeared due to postthrombophlebitic disease, in 25 patients (19.8%) due to primary varicose veins of lower limbs, in 15 (11.9%) patients due to obliterative diseases of peripheral vessels and in 12 (9.5%)--other diseases. The duration of the illness made up from 1 to 50 years. In 26 patients (group 1) low-intensity laser irradiation (LLI) was used together with combined conservative therapy; in 32 patients (group 2) hyperbaric oxygenation (HBO), in 21 (3 group)--combined application of LLI and HBO was used. The examination of regional macrohemodynamics and microcirculation in 39 patients showed decrease of rheographic index (RI) in the shin, increase of the arterioles tone and venous outflow disturbance. The use of LLI and HBO resulted in undoubtful increase of RI and improvement of microcirculatory indexes. As a result of combined application of LLI and HBO microflora of the ulcers lowered from 10 and 10 per 1 gr in patients of group 1 and 2, respectively, in patients of group 3 there was no growth of pathogenic microflora. The investigation of humoral and cellular immunity after the application of LLI and HBO demonstrated strong immunocorrective action.

摘要

对126例下肢营养性溃疡患者的治疗结果进行了分析。74例(58.7%)患者的营养性溃疡由血栓性静脉炎后疾病引起,25例(19.8%)由下肢原发性静脉曲张引起,15例(11.9%)由外周血管闭塞性疾病引起,12例(9.5%)由其他疾病引起。病程为1至50年。26例患者(第1组)采用低强度激光照射(LLI)联合综合保守治疗;32例患者(第2组)采用高压氧治疗(HBO),21例(第3组)采用LLI与HBO联合应用。对39例患者的局部宏观血流动力学和微循环检查显示,小腿血流图指数(RI)降低,小动脉张力增加,静脉回流障碍。LLI和HBO的使用无疑导致RI增加和微循环指标改善。由于LLI和HBO联合应用,第1组和第2组患者溃疡处的微生物群分别从每克10和10降低,第3组患者中致病性微生物群没有生长。应用LLI和HBO后对体液和细胞免疫的研究显示出强大的免疫纠正作用。

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