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目的探讨下肢静脉性溃疡个体化治疗的临床效果和可行性。方法回顾性分析2012年2月至2014年2月期间我院采用个体化治疗的下肢静脉性溃疡患者360例(共421条肢体),其中男126例,女234例;年龄45~78岁,中位年龄53岁;位于左下肢176例,右下肢123例,双下肢61例。所有患者依据术前彩色多普勒超声定位、标记进行个体化治疗方案选择,对功能不全的交通静脉予以结扎,术后穿着弹力袜等。临床观察指标为患者术后恢复正常活动时间、疼痛程度VAS评分、围手术期并发症发生情况,随访溃疡愈合及复发情况。结果所有患者均按计划完成手术,手术时间平均35 min。术后8 h VAS评分平均2.6分,24 h时VAS评分平均为1.5分,疼痛基本消失。术后完全恢复正常活动平均为3 d。围手术期发生术后切口出血5例,溃疡周围切口感染32条肢体。术后随访12~24个月,溃疡均愈合,复发9例。结论个体化治疗下肢静脉性溃疡具有安全、有效、并发症少、溃疡愈合速度快、患者术后疼痛轻的优点。
Objective To investigate the clinical effect and feasibility of individualized treatment of venous leg ulcers. Methods A total of 360 cases (421 limbs) of lower extremity venous ulcer in our hospital from February 2012 to February 2014 were retrospectively analyzed. There were 126 males and 234 females, aged 45-78 years old, The median age of 53 years; located in 176 cases of the left lower limb, right lower limb 123 cases, 61 cases of both lower extremities. All patients according to preoperative color Doppler ultrasound location, marking the individual treatment options, to the insufficiency of the traffic vein to be ligation, postoperative elastic stockings and so on. The clinical observation indexes were the recovery time of normal operation, the VAS score of pain, the incidence of perioperative complications, the healing and recurrence of ulcer. Results All patients completed the operation according to plan, the average operation time was 35 min. The VAS score was 2.6 points at 8 hours and 1.5 points at 24 hours. The pain disappeared. The average rate of complete recovery to normal activity was 3 days after operation. Perioperative wound incision occurred in 5 cases of incision wound infection 32 limbs. All patients were followed up for 12-24 months. All the ulcers healed and relapsed in 9 cases. Conclusion Individualized treatment of venous leg ulcers with lower extremities is safe, effective, less complications, ulcer healing speed, postoperative pain relief advantages.