Wipke-Tevis D D, Stotts N A
Sinclair School of Nursing, University of Missouri-Columbia 65211, USA.
J Vasc Nurs. 1998 Sep;16(3):48-56. doi: 10.1016/s1062-0303(98)90001-2.
The purpose of the prospective study described in this article was to explore nutrition, tissue oxygenation, and healing in venous ulcer patients. Nutritional risk, anthropometric measures, biochemical indices, two 3-day dietary records, and transcutaneous tissue oxygen levels were obtained. Wound surface area was evaluated 2 times, 4 weeks apart. A convenience sample of 25 English-speaking persons with 1 or more venous ulcers participated (mean age 59.8 years, 60% men, 48% white). Moderate or high nutritional risk existed in 84% of the persons in the sample. Based on body mass index, more than 50% of the persons in the sample were obese. Nonetheless, 17 of 25 persons in the sample had 1 or more abnormal biochemical nutritional indices. In addition, caloric intake (17 of 20), protein intake (15 of 20), and zinc intake (17 of 20) were inadequate to meet the needs for healing. No statistically significant relationships were found between biochemical nutritional indices, tissue oxygenation, and healing. The women in the sample were more likely to heal than were the men (P < 0.05). This study begins to document the problems of overnutrition and undernutrition in the venous ulcer population. Future studies need to explore the effects of obesity and inadequate intake on the healing of venous ulcers. Additional examination of the differences between men and women also is warranted to identify predictors of venous ulcer healing.
本文所述前瞻性研究的目的是探究静脉溃疡患者的营养状况、组织氧合及愈合情况。获取了营养风险、人体测量指标、生化指标、两份为期3天的饮食记录以及经皮组织氧水平。分别在相隔4周的时间对伤口表面积进行了2次评估。选取了25名患有1处或多处静脉溃疡的英语使用者作为便利样本（平均年龄59.8岁，60%为男性，48%为白人）。样本中84%的人存在中度或高度营养风险。根据体重指数，样本中超过50%的人肥胖。尽管如此，样本中25人中有17人存在1项或多项异常的生化营养指标。此外，热量摄入（20人中有17人）、蛋白质摄入（20人中有15人）和锌摄入（20人中有17人）均不足以满足愈合需求。未发现生化营养指标、组织氧合与愈合之间存在统计学上的显著关系。样本中的女性比男性更易愈合（P<0.05）。本研究开始记录静脉溃疡人群中营养过剩和营养不足的问题。未来的研究需要探究肥胖和摄入不足对静脉溃疡愈合的影响。还需要进一步研究男性和女性之间的差异，以确定静脉溃疡愈合的预测因素。
