COMMUNITY CLINICS FOR LEG ULCERS AND IMPACT ON HEALING
COMMUNITY CLINICS FOR LEG ULCERS AND IMPACT ON HEALING
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DOI：
10.1136/bmj.305.6866.1389
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发表时间：
1992-12-05
影响因子：
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通讯作者：
MCCOLLUM, CN
中科院分区：
文献类型：
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作者：
MOFFATT, CJ;FRANKS, PJ;MCCOLLUM, CN
设计-所有腿部溃疡患者被邀请到社区诊所，提供在医院研究诊所开发的治疗。无严重动脉疾病的患者（多普勒踝/臂指数> 0.8）用四层高压缩绷带治疗。设置-在查令十字血管外科服务支持下，在滨江区卫生局的健康中心举行的六个社区诊所。患者-所有腿部溃疡的患者都转介到社区服务，不考虑溃疡的原因和持续时间。主要结果测量-完全愈合的时间由寿命表法。结果-550溃疡腿被认为是在475例患者的平均（SD）年龄73.8（11.9）岁。有477例静脉溃疡，中位尺寸为4.2 cm 2（范围为0.1-117 cm 2），128例大于10 cm 2。这些溃疡的平均存在时间为3个月（范围为1周至63年），其中150例存在时间超过1年。社区诊所的四层包扎在12周内使318例（69%）静脉溃疡完全愈合，在24周内使375例（83%）静脉溃疡完全愈合。有56名患者踝/肱动脉压指数< 0.8，表明动脉疾病。压力指数0.5的50例患者接受减压治疗，24例（56%）在12周内愈合，31例（75%）在24周内愈合。所有腿部溃疡的整体愈合的数字分别为351/550（67%）在12周和417/550（81%）在24周，相比之下，只有11/51（22%）在12周前的社区诊所成立up. Conclusions社区诊所静脉溃疡提供了一种有效的手段，实现愈合的大多数患者腿部溃疡。
Objective-To evaluate the effectiveness of community clinics for leg ulcers.Design-All patients with leg ulceration were invited to community clinics that offered treatment developed in a hospital research clinic. Patients without serious arterial disease (Doppler ankle/brachial index > 0.8) were treated with a high compression bandage of four layers.Setting-Six community clinics held in health centres in Riverside District Health Authority supported by the Charing Cross vascular surgical service.Patients-All patients referred to the community services with leg ulceration, irrespective of cause and duration of ulceration.Main outcome measures-Time to complete healing by the life table method.Results-550 ulcerated legs were seen in 475 patients of mean (SD) age 73.8 (11.9) years. There were 477 venous ulcers of median size 4.2 cm2 (range 0.1-117 cm2), 128 being larger than 10 cm2. These ulcers had been present for a median of three months (range one week to 63 years) with 150 present for over one year. Four layer bandaging in the community clinics achieved complete healing in 318 (69%) venous ulcers by 12 weeks and 375 (83%) by 24 weeks. There were 56 patients with an ankle/brachial arterial pressure index < 0.8, indicating arterial disease. The 50 patients with pressure index 0.5 were treated with reduced compression, and 24 (56%) healed by 12 weeks and 31 (75%) by 24 weeks. The figures for overall healing for all leg ulcers were 351/550 (67%) at 12 weeks and 417/550 (81%) at 24 weeks, compared with only 11/51 (22%) at 12 weeks before the community clinics were set up.Conclusions-Community clinics for venous ulcers offer an effective means of achieving healing in most patients with leg ulcers.