Filho J P, Sampaio-Barros P D, Parente J B, Menezes F H, Potério G B, Samara A M, Marques Neto J F
Department of Surgery, Hospital de Clínicas of the State University of Campinas School of Medicine, SP, Brazil.
J Rheumatol. 1998 Aug;25(8):1540-3.
To evaluate the usefulness of rhythmic external compression (REC) of the limbs on the healing of ischemic cutaneous ulcers in systemic sclerosis (SSc).
A prospective study analyzing 17 patients with SSc with symptomatic ischemic cutaneous ulcers in the limbs of more than 4 weeks' duration, who submitted to 20 sessions of REC, each session of one hour duration, 3 times a week. Patients were assessed at study entry, at the end of REC sessions, and at 30, 60, and 90 days after treatment. We also conducted a retrospective analysis of the outcome of ischemic vascular ulcers in a group of 20 patients with SSc who did not undergo REC.
Twenty-eight ischemic vascular ulcers were submitted to REC. There was complete healing of 20 ulcers (71%) at the end of REC sessions. The healing was statistically more frequent in the distal ulcers (fingers and toes) (p = 0.0289), independent of SSc variant. There was a statistically significant correlation between pain resolution until the 15th session of REC and future ulcer healing (p < 0.0001). At followup, there were relapses in 2 ulcers 30 days after treatment. In the 20 patients with SSc who did not undergo REC, at followup, after 90 days of conventional treatment, there was healing of 7 ulcers (35%).
REC could represent a therapeutic option in the treatment of ischemic cutaneous ulcers in SSc.
评估肢体节律性外部加压（REC）对系统性硬化症（SSc）缺血性皮肤溃疡愈合的有效性。
一项前瞻性研究，分析17例患有肢体症状性缺血性皮肤溃疡且病程超过4周的SSc患者，这些患者接受了20次REC治疗，每次治疗持续1小时，每周3次。在研究开始时、REC治疗结束时以及治疗后30、60和90天对患者进行评估。我们还对一组未接受REC治疗的20例SSc患者的缺血性血管溃疡结局进行了回顾性分析。
28个缺血性血管溃疡接受了REC治疗。REC治疗结束时，20个溃疡（71%）完全愈合。远端溃疡（手指和脚趾）的愈合在统计学上更常见（p = 0.0289），与SSc亚型无关。在REC治疗的第15次疗程之前疼痛缓解与未来溃疡愈合之间存在统计学显著相关性（p < 0.0001）。随访时，治疗后30天有2个溃疡复发。在20例未接受REC治疗的SSc患者中，随访时，经过90天的传统治疗后，7个溃疡（35%）愈合。
REC可能是治疗SSc缺血性皮肤溃疡的一种治疗选择。
