经皮透光负压旋切术治疗下肢静脉性皮肤溃疡的疗效与评价

Assessment and Curative Effect of Percutem Transilluminated with Negative Pressured on The Potaried Technique on Treatment of Venous Ulcer in Lower Extremity

目的评价经皮透光负压旋切术治疗下肢静脉性皮肤溃疡的临床疗效。方法选择下肢静脉性皮肤溃疡300例300条下肢,其中,经皮透光负压旋切术治疗组(简称旋切组)190例190条下肢,经皮缝扎术组(简称缝扎组)110例110条下肢。于术后5、20、120及360d分别观察2组患者的皮肤感染率及皮肤坏死率、色素减退率及创面收缩率、溃疡愈合率及溃疡复发率6项临床指标。结果术后5d皮肤感染率和皮肤坏死率旋切组低于缝扎组(P<0.05);术后20d创面收缩率与色素减退率旋切组高于缝扎组(P<0.05);术后120d溃疡愈合率旋切组与缝扎组相近(P>0.05);术后360d溃疡复发率旋切组低于缝扎组(P<0.05)。结论经皮透光负压旋切术可有效促进下肢静脉性皮肤溃疡的愈合,并在减轻皮肤感染及皮肤再损伤方面具有较明显优势。

Objective To assess the curative effect of percutem transilluminated with negative pressured on the potaried technique on the treatment of venous ulcer in lower extremity.Methods The clinical date of 300 cases involving 300 legs with venous ulcer in lower extremity,who underwent the percutum transilluminated negative pressured potaried technique using TRIVEXTM Ⅱ potaried system or the percutum transfixion surgical treatment from October 2005 to June 2009,were analyzed.Three hundred cases were randomly divided into potaried group and transfixion group. In potaried group, there were 190 cases involving 190 legs treated with TRIVt^XTM ]I pota- ried system. In transfixion group, 110 cases involving 110 legs treated with pereutum transfixion. The clinical inde- xes of skin infection rate and skin necrosis rate, shrinkage rate of wound area and skin depigmentation rate, ulcer healing rate and ulcer recurrence rate were calculated to assess the clinical curative effect on day 5, day 20, day 120 and day 360 after operation respectively. Results The rates of skin infection and skin necrosis were significantly de- creased in potaried group compared with transfixion group on day 5 after operation （P〈0.05）, the rates of shrink- age of wound area and skin depigmentation were significantly increased in potaried group compared with transfixion group on day 20 （P〈0.05）. The ulcer healing rate was not significantly different between the two groups on day 120 （P〉0.05）. Ulcer recurrence rate was remarkably lower in potaried group than that in transfixion group on day 360 （P〈0.05）. Conclusion It can be concluded that percutem transilluminated with negatived pressured on the po- taried technique with TRIVEXTM Ⅱ potaried system can efficiently promote the healing of venous ulcer in the lower extremity, and at the same time it has an ascendancy in lessening skin infection and skin reinjury.