Venous ulcer of lower extremities is a serious manifestation of venous insufficiency of lower extremities in the later stage,which is characterized by inflammatory exudation at the initial stage,followed by skin ruptu...Venous ulcer of lower extremities is a serious manifestation of venous insufficiency of lower extremities in the later stage,which is characterized by inflammatory exudation at the initial stage,followed by skin rupture,and finally forms the whole layer of skin atrophy and necrosis,which does not heal for a long time.How to promote ulcer healing is the most important problem in the treatment of venous ulcers of lower extremities.Vacuum sealing drainage(VSD)is constantly used in clinic and plays a unique advantage in wound healing.This paper mainly reviews the present situation of venous ulcer of lower extremities and summary,principle,application progress,attentions and prospect of VSD at home and abroad.展开更多
Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods:...Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods: Domestic databases in the past 20 years (January 1999-December 2019) were searched by computer, including China Journal Full-text Database (CNKI), VIP, Wanfang and CBM. Literature was screened according to inclusion and exclusion criteria. Cochrane risk assessment tool was used to evaluate the quality of the included literature. Two-classification method was used to extract data. RevMan 5.3 software was used to make statistical analysis of the data. Results: Eleven articles were finally included, totaling 1,576 patients, 804 cases in the treatment group and 772 cases in the control group. Meta-analysis results show that there is no difference in heterogeneity and bias among the included literatures. The total effective rate (risk ratio [RR]=1.12, 95% confidence interval [CI]=1.09-1.15) of integrated traditional Chinese and western medicine in treating venous ulcer of lower limbs is higher, which is obviously better than that of western medicine alone. Conclusion: Through data analysis, it is concluded that in the study population, the treatment of integrated traditional Chinese and western medicine has a significant effect on venous ulcer of lower limbs. Make up for the deficiency of simple western medicine treatment, improve the cure rate and reduce the recurrence rate. However, there is currently a lack of relevant high-quality literature, so a large sample size, rigorous and standardized experimental design and randomized double-blind clinical study are needed to further test the conclusions.展开更多
Introduction: Cutaneous manifestations of systemic sclerosis (SSc) include skin ulceration;4% - 12% of patients with SSc develop lower extremity ulcers of various etiologies. Limited data, significant morbidity, and s...Introduction: Cutaneous manifestations of systemic sclerosis (SSc) include skin ulceration;4% - 12% of patients with SSc develop lower extremity ulcers of various etiologies. Limited data, significant morbidity, and substantial cost of wound care led us to undertake this study to describe and identify risk factors. Methods: After Institutional Review Board approval, we identified 30 patients with SSc and lower extremity ulcers over a 10-year period at a single center with an SSc clinic, which were included in a descriptive analysis. Results: Median age of onset of lower extremity ulcers was 59.5 years (range 20 - 84). Ninety percent of patients were female, 60% were Caucasian, 63% had limited SSc, 13% diffuse SSc and 23% an overlap syndrome. Immunomodulators or steroids were prescribed in 53%;hypercoagulable state identified in 16%. Ulcers were attributed to venous stasis (27%), SSc (20%), trauma (20%), arterial disease (17%), and multifactorial/unknown (17%). In patients with ulcers attributed to SSc, age at onset was lower (45.5 vs 59.5 years). Biopsies generally did not contribute to management. Multidisciplinary treatment was routine;20% required amputation, 10% endovascular intervention, 20% frequent surgical debridement, 10% hyperbaric oxygen, 26% local treatment and antibiotics and 13% received immunosuppression for wound treatment. Conclusion: Lower extremity ulcers are a serious clinical problem in patients with SSc. The clinical exam, venous dopplers, ankle-brachial indices and assessment of vascular risk factors helped define causality. In younger patients, ulcers were more frequently attributed to SSc and these patients were more likely to be on immunosuppressants/DMARDS, possibly indicating severe phenotype of SSc.展开更多
下肢静脉性溃疡(Venous leg ulcers,VLU)是慢性静脉疾病发展晚期的阶段,具有病程长、难愈合、易复发的特点,严重影响患者生活质量。下肢静脉性溃疡属于中医学“臁疮”范畴,中医学在治疗该病方面积累了丰富的经验,此文对下肢静脉性溃疡...下肢静脉性溃疡(Venous leg ulcers,VLU)是慢性静脉疾病发展晚期的阶段,具有病程长、难愈合、易复发的特点,严重影响患者生活质量。下肢静脉性溃疡属于中医学“臁疮”范畴,中医学在治疗该病方面积累了丰富的经验,此文对下肢静脉性溃疡发病机制、中医病因病机进行阐述,浅析中医外治法促进溃疡愈合的作用。展开更多
目的探讨八段锦训练在下肢静脉溃疡患者中的应用效果。方法2022年3月至2023年1月,便利抽样法选取在合肥市第二人民医院接受治疗的72例下肢静脉溃疡患者为研究对象,将其随机分为常规治疗加八段锦训练组(观察组)和单纯常规治疗组(对照组)(...目的探讨八段锦训练在下肢静脉溃疡患者中的应用效果。方法2022年3月至2023年1月,便利抽样法选取在合肥市第二人民医院接受治疗的72例下肢静脉溃疡患者为研究对象,将其随机分为常规治疗加八段锦训练组(观察组)和单纯常规治疗组(对照组)(36/组)。在干预前、干预6周及干预12周后进行评估,主要结果为伤口愈合量表(pressure ulcer scale for healing,PUSH)计分、愈合率;次要结果包括踝-后足评分系统(ankle hindfoot scale,AOFAS)评分、视觉模拟疼痛量表(visual analogue pain scale,VAS)评分、下肢静脉溃疡患者生活质量(venous leg ulcer quality of life questionnaire,VLU-QoL)得分。结果干预6周、12周后两组患者PUSH计分、AOFAS评分、VAS评分在组间效应、时间效应和交互作用上均存在统计学意义(P<0.05);干预12周后两组患者伤口愈合率、VLU-QoL各维度得分均存在统计学意义(P<0.05)。结论八段锦训练能有效提升下肢静脉溃疡患者创面治疗效果和生活质量,降低溃疡疼痛程度。展开更多
基金General project of national natural science foundation(No.81774310)The national natural science foundation youth project(No.81804095).
文摘Venous ulcer of lower extremities is a serious manifestation of venous insufficiency of lower extremities in the later stage,which is characterized by inflammatory exudation at the initial stage,followed by skin rupture,and finally forms the whole layer of skin atrophy and necrosis,which does not heal for a long time.How to promote ulcer healing is the most important problem in the treatment of venous ulcers of lower extremities.Vacuum sealing drainage(VSD)is constantly used in clinic and plays a unique advantage in wound healing.This paper mainly reviews the present situation of venous ulcer of lower extremities and summary,principle,application progress,attentions and prospect of VSD at home and abroad.
基金National Natural Science Foundation of China Youth Program(No.81804095)Project of Collaborative Innovation Center for Traditional Chinese Medicine Health Services in Shanghai(No.ZYJKFW201701002)
文摘Objective: To test the therapeutic effect of integrated traditional Chinese and western medicine on venous ulcer of lower limbs by Meta analysis method, and then to propose the best clinical treatment scheme. Methods: Domestic databases in the past 20 years (January 1999-December 2019) were searched by computer, including China Journal Full-text Database (CNKI), VIP, Wanfang and CBM. Literature was screened according to inclusion and exclusion criteria. Cochrane risk assessment tool was used to evaluate the quality of the included literature. Two-classification method was used to extract data. RevMan 5.3 software was used to make statistical analysis of the data. Results: Eleven articles were finally included, totaling 1,576 patients, 804 cases in the treatment group and 772 cases in the control group. Meta-analysis results show that there is no difference in heterogeneity and bias among the included literatures. The total effective rate (risk ratio [RR]=1.12, 95% confidence interval [CI]=1.09-1.15) of integrated traditional Chinese and western medicine in treating venous ulcer of lower limbs is higher, which is obviously better than that of western medicine alone. Conclusion: Through data analysis, it is concluded that in the study population, the treatment of integrated traditional Chinese and western medicine has a significant effect on venous ulcer of lower limbs. Make up for the deficiency of simple western medicine treatment, improve the cure rate and reduce the recurrence rate. However, there is currently a lack of relevant high-quality literature, so a large sample size, rigorous and standardized experimental design and randomized double-blind clinical study are needed to further test the conclusions.
文摘Introduction: Cutaneous manifestations of systemic sclerosis (SSc) include skin ulceration;4% - 12% of patients with SSc develop lower extremity ulcers of various etiologies. Limited data, significant morbidity, and substantial cost of wound care led us to undertake this study to describe and identify risk factors. Methods: After Institutional Review Board approval, we identified 30 patients with SSc and lower extremity ulcers over a 10-year period at a single center with an SSc clinic, which were included in a descriptive analysis. Results: Median age of onset of lower extremity ulcers was 59.5 years (range 20 - 84). Ninety percent of patients were female, 60% were Caucasian, 63% had limited SSc, 13% diffuse SSc and 23% an overlap syndrome. Immunomodulators or steroids were prescribed in 53%;hypercoagulable state identified in 16%. Ulcers were attributed to venous stasis (27%), SSc (20%), trauma (20%), arterial disease (17%), and multifactorial/unknown (17%). In patients with ulcers attributed to SSc, age at onset was lower (45.5 vs 59.5 years). Biopsies generally did not contribute to management. Multidisciplinary treatment was routine;20% required amputation, 10% endovascular intervention, 20% frequent surgical debridement, 10% hyperbaric oxygen, 26% local treatment and antibiotics and 13% received immunosuppression for wound treatment. Conclusion: Lower extremity ulcers are a serious clinical problem in patients with SSc. The clinical exam, venous dopplers, ankle-brachial indices and assessment of vascular risk factors helped define causality. In younger patients, ulcers were more frequently attributed to SSc and these patients were more likely to be on immunosuppressants/DMARDS, possibly indicating severe phenotype of SSc.
文摘下肢静脉性溃疡(Venous leg ulcers,VLU)是慢性静脉疾病发展晚期的阶段,具有病程长、难愈合、易复发的特点,严重影响患者生活质量。下肢静脉性溃疡属于中医学“臁疮”范畴,中医学在治疗该病方面积累了丰富的经验,此文对下肢静脉性溃疡发病机制、中医病因病机进行阐述,浅析中医外治法促进溃疡愈合的作用。
文摘目的探讨八段锦训练在下肢静脉溃疡患者中的应用效果。方法2022年3月至2023年1月,便利抽样法选取在合肥市第二人民医院接受治疗的72例下肢静脉溃疡患者为研究对象,将其随机分为常规治疗加八段锦训练组(观察组)和单纯常规治疗组(对照组)(36/组)。在干预前、干预6周及干预12周后进行评估,主要结果为伤口愈合量表(pressure ulcer scale for healing,PUSH)计分、愈合率;次要结果包括踝-后足评分系统(ankle hindfoot scale,AOFAS)评分、视觉模拟疼痛量表(visual analogue pain scale,VAS)评分、下肢静脉溃疡患者生活质量(venous leg ulcer quality of life questionnaire,VLU-QoL)得分。结果干预6周、12周后两组患者PUSH计分、AOFAS评分、VAS评分在组间效应、时间效应和交互作用上均存在统计学意义(P<0.05);干预12周后两组患者伤口愈合率、VLU-QoL各维度得分均存在统计学意义(P<0.05)。结论八段锦训练能有效提升下肢静脉溃疡患者创面治疗效果和生活质量,降低溃疡疼痛程度。
