经皮透光负压旋切术治疗下肢深静脉血栓形成继发皮肤溃疡的临床研究

Percutaneous potaried with light transmission and negativepressured technique for the treatment on venous skin ulcerwith the deep venous thrombosis sequelae in lower limb

目的:探讨下肢深静脉血栓形成(DVTS)继发皮肤溃疡的微创治疗方法。方法:选择DVTS继发皮肤溃疡患者116例,其中经皮透光负压旋切术治疗72例72条下肢(A组),非手术治疗44例44条下肢(B组)。于A组术后5、20、120和360 d(即B组入院后8、23d、出院后97、337 d)记录皮肤的感染率、坏死率、色素减退率、创面收缩率、溃疡愈合率及溃疡复发率等6项临床指标。结果:术后5 d A组皮肤感染率和皮肤坏死率低于B组(P<0.05);术后20 d A组创面收缩率与色素减退率较B组显著改善(P<0.05);术后120 d A组溃疡愈合率较B组显著升高(P<0.05);术后360 d溃疡复发率A组显著低于B组(P<0.05)。结论:经皮透光负压旋切术治疗DVTS继发皮肤溃疡效果良好,具有微创性、可操作性、可控制性等特点,可作为外科治疗方法之一。

Objective： To investigate the feasibility technique and security principle of treatment for venous skin ulcer with deep venous thrombosis sequelae in the lower limbs.Methods： We randomly assigned 116 patients with venous skin ulcer with deep venous thrombosis sequelae in the lower limbs from October 200 to March 2009,to percutaneous potaried with light transmission and negative pressured treatment,72 patients involving 72 legs（group A）;and control group,44 patients involving 44 legs（no surgical treatment,group B）.The clinical index of skin infection rate,skin necrosis rate,shrinkage rate of wound area,skin depigmentation rate,ulcer healing rate and ulcer recurrence rate were used to assess the clinical curative effect between group A and group B at 5 day,20 day,120 day and 360 day after the operation respectively.Results： The clinical results demonstrated that the rate of skin infection and skin necrosis was significantly decreased in group A compared with group B at 5 day after operation（P0.05）;the rate of shrinkage of wound area and skin depigmentation was significantly different between group A and group B at 20 day（P0.05）;ulcer healing rate was significantly different between group A and group B at 120 day（P0.05）;ulcer recurrence rate was remarkably lower in group A compared with group B at 360 day（P0.05）.Conclusions： The percutaneous potaried with light transmission and negative pressured can be used to treat the venous skin ulcer from deep venous thrombosis in lower limbs,and is one of the better treatment as a minimally invasive surgery.