组织工程与重建外科杂志 ›› 2026, Vol. 22 ›› Issue (1): 78-.

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下肢静脉溃疡的综合治疗与效果评价研究

  

  • 出版日期:2026-01-29 发布日期:2026-03-06

Research on the comprehensive treatment and efficacy evaluation of venous leg ulcers

  • Online:2026-01-29 Published:2026-03-06

摘要:

目的 探讨下肢静脉溃疡(Venous leg ulcer,VLU)的综合诊疗策略,评估治疗效果。方法 回顾性分析我科2023 年 1 月至 2024 年 9 月共 15 例符合 C5-C6 诊断的下肢静脉溃疡患者,溃疡面积 1.5 cm×1.5 cm~10 cm×20 cm,其中13 例溃疡深及真皮脂肪层,2例有骨和肌腱外露。术前应用下肢血管多普勒超声、顺行性静脉造影等方法评估下肢血管情况,确定治疗方案。综合治疗方法包括静脉高压处理、清创换药和自体富血小板血浆(Platelet-rich plasma,PRP)注射、创面修复(植皮和皮瓣移植)、术后穿戴静脉曲张加压袜,在病变部位定期注射PRP。出院后随访6个月到1年。治疗及随访过程中多时间点记录溃疡愈合率、CIVIQ-10评分与静脉病变临床严重程度评分。结果 本组病例溃疡均在术后4~6周内完全愈合(愈合率为100%)。截至随访结束,14例患者无溃疡复发,1例患者复发;所有患者CIVIQ-10评分升高,静脉病变临床严重程度评分降低。结论 术前准确评估下肢血管和创面情况,处理静脉高压,利用清创、PRP注射、手术来修复创面,术后穿戴加压袜,以及出院后定期PRP注射等综合治疗措施,能有效提高下肢静脉溃疡愈合率,降低复发率,显著改善患者生活质量。

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Abstract:

fect. Methods The clinical data of 15 patients with C5-C6 VLU from January 2023 to September 2024 were
retrospectively reviewed. The size of ulcers ranged from 1.5 cm×1.5 cm to 10 cm×20 cm, of which 13 cases were deep to the dermis-fat layer, and 2 cases had exposed bone and muscle tendon. Lower extremity Doppler ultrasound and antegrade lower extremity venography angiography were used to evaluate the vascular condition of the lower extremity before determining treatment scheme. The comprehensive treatment scheme includes the management of venous hypertension, debridement, platelet-rich plasma (PRP) injection, wound repair (free skin grafting or skin flap grafting), postoperative wearing vein pressure stockings for varicose, and regular PRP injection for lesion site. The patients were followed up for 6 months to 1 year after discharge. Healing rate of ulcer, CIVIQ-10 score and clinical severity score of venous lesions were recorded at multiple points during treatment and follow up. Results The ulcers in this group healed completely within 4-6 weeks after surgery (healing rate was 100%). At the end of follow-up period,14 patients had no ulcer recurrence and 1 patient had recurrence. All patients had elevated scores of CIVIQ-10 and reduced scores of VCSS. Conclusion A comprehensive treatment scheme combining accurate preoperative evaluation of lower limb vascular and wound, management of venous hypertension, repairing wound by debridement, PRP injection and surgery, postoperative wearing pressure stockings and regular PRP injections after being discharged from the hospital can effectively increase the healing rate of VLU, reduce the rate of recurrence, and significantly improve the patient's quality of life.

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