Venous ulcer reappraisal: Insights from an international task force
Venous ulcer reappraisal: Insights from an international task force
复制标题
DOI：
10.1159/000054073
复制
发表时间：
1999-01-01
影响因子：
1.7
通讯作者：
Clement, DL
中科院分区：
文献类型：
--
作者：
Clement, DL
一个由16名专家组成的国际工作队受权审查和客观评价腿部慢性静脉疾病的各个方面。通过计算机检索确定了1983年至1997年有关腿部慢性静脉疾病的所有文献。然后进行了三次不同的筛选，以便仅选择提供中等到强有力的科学证据的相关论文。根据这些出版物得出最终结论和进一步的治疗建议。压迫、药物、局部治疗、硬化疗法和手术是现有的治疗选择，可以提出以下建议。压迫：固定和拉伸的绷带都被证明是有效的。可以使用压缩长袜。压缩需要超过35 mm Hg。药物治疗：虽然初步结果表明，几种血管扩张剂和口服微粉化纯化黄酮部分的有益效果，静脉溃疡愈合的药物疗效的证据仍然是有限的，需要进一步的研究才能提出建议。没有证据表明常规使用抗生素。局部治疗具有尚未证实的预防作用。硬化疗法不太可能有效，除非有浅表静脉功能不全，其中它可能有一个尚未证实的作用。手术：活动性静脉溃疡和隐股或隐腘交界处功能不全的患者可从手术治疗中获益。在没有反流或深静脉血栓形成的情况下，没有证据支持手术治疗。
An international task force made up of a panel of 16 experts was mandated to review and objectively evaluate all aspects of chronic venous disease of the leg. All available publications on chronic venous disease of the leg from 1983 to 1997 were identified through computerized search. Three different screenings were then performed in order to select only relevant papers providing moderate to strong scientific evidence. Final conclusions and further therapeutic recommendations were made based on these publications. Compression, medications, local therapies, sclerotherapy and surgery are the existing therapeutic options for which the following recommendations can be made. Compression: Properly applied bandages both fixed and stretched have been shown to be effective. Compression stockings may be used. Compression needs to be in excess of 35 mm Hg. Medications: Although preliminary results have shown a beneficial effect of several vasodilators and oral micronized purified flavonoid fraction, the evidence for the efficacy of medications on venous ulcer healing is still limited and further studies are required before recommendations can be made. There is no evidence to routinely administer antibiotics. Local therapies have an as yet unproven adjunctive role. Sclerotherapy is unlikely to be effective unless there is superficial venous insufficiency, in which it may have an as yet unproven role. Surgery: Patients with active venous ulcer and sapheno-femoral or sapheno-popliteal junction incompetence benefit from surgical treatment. In the absence of reflux or following deep vein thrombosis, there is no evidence to support surgical treatment.