慢性皮肤溃疡172例临床表现及难愈原因分析  

Clinical features and refractory healing causes of chronic skin ulcers in 172 cases

作　　者：谭杨[1] 李凤[1] 成琼辉[1] 伍津津[1] 雷霞[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所皮肤科,重庆400042

出　　处：《创伤外科杂志》2016年第5期288-290,共3页Journal of Traumatic Surgery

基　　金：国家自然科学基金资助项目(81271760)

摘　　要：目的进一步了解慢性皮肤溃疡的临床表现、常见病因及难愈原因,为制定防治策略提供参考依据。方法笔者对2011年1月-2013年12月确诊的172例慢性皮肤溃疡住院患者的临床资料进行回顾性分析,其中男性118例,女性54例;年龄14-92岁,平均（54.1±18.3）岁。平均病程765.3d,平均溃疡面积26.2cm^2。结果 130例患者皮肤溃疡位于双下肢,86例由创伤诱发;58例患者细菌培养为革兰阳性菌,72例为革兰阴性菌。营养不良、细菌感染、处理不当、血供不佳、合并疾病为其主要难愈原因。结论男性好发,中老年发病最多,下肢尤其是小腿为最主要发病部位,铜绿假单胞菌上升为最主要的感染细菌,下肢静脉曲张和糖尿病患者患慢性皮肤溃疡的风险较高。Objective To further identify the clinical features, common causes and refractory healing of chronic skin ulcer, and to provide evidence for effective preventing and treating strategy for this disease. Methods Retrospective analysis of clinical information from 172 cases of chronic skin ulcers in our hospital from Jan. 2011 to Dec. 2013 was carried out. Among the 172 cases, 118 were males and 54 were females;the mean age was （54. 1 ±18.3） years （ 14-92） years. The average clinical course was 765.3 d and the average ulcerous areas was 26.2cm. Results Totally 130 ulcers cases were in the lower limbs and 86 ulcers cases were caused by trauma. Bacterial cultures indicated that 58 cases were gram positive while 72 cases were gram negative. Main factors influencing ulcer healing were nutritional conditions, bacterial infections,inappropriate treatments,insufficient blood supply and accompanied diseases. Conclusion Chronic skin ulcers are easily occurred in males and in elderly patients; lower limbs are the main pathogenic sites; pseudomonas aeruginosa is the main pathogenic bacteria; patients with varicose vein of lower limb and diabetes have high risk of suffering chronic skin ulcers.

关 键 词：皮肤溃疡 感染 细菌 

分 类 号：R632.1[医药卫生—外科学]