下肢静脉溃疡患者溃疡复发的高危因素分析  

Analysis of high-risk factors for ulcer recurrence in patients with venous leg ulcers

作　　者：欧娟娟[1] 蔡秋妮[1] 洪诗钗 OU Juanjuan;CAI Qiuni;HONG Shichai(Department of Nephrology/Department of Vascular Surgery,Zhongshan Hospital,Xiamen University,Xiamen,Fujian 361004,China;Department of Vascular Surgery,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen,Fujian 361015,China)

机构地区：[1]厦门大学附属中山医院肾内科/血管外科,福建厦门361004 [2]复旦大学附属中山医院厦门医院血管外科,福建厦门361015

出　　处：《中国普通外科杂志》2023年第6期909-914,共6页China Journal of General Surgery

基　　金：福建省厦门市科技局医疗卫生指导性基金资助项目(3502Z20209047)。

摘　　要：背景与目的:下肢静脉溃疡是下肢慢性静脉功能不全后期严重的并发症,复发率高,可导致患者住院时间延长、加重患者经济负担、降低劳动能力、增加残疾等。因此,本研究探讨下肢静脉溃疡患者溃疡复发高危因素,旨在为有效预防下肢静脉溃疡复发提供临床依据。方法:回顾性分析厦门大学附属中山医院2021年1月—2022年9月收治的下肢静脉溃疡患者的临床资料。用单因素与多因素Logistic分析下肢静脉溃疡患者复发的高危因素。结果:共纳入下肢静脉溃疡患者182例,所有患者均在慢性伤口门诊接受规范化换药治疗。下肢静脉溃疡复发率为47.2%。单因素分析结果发现,有无行手术干预(χ2=19.206,P=0.000)、有无穿弹力袜(χ2=23.590,P=0.000)、是否重体力活动(χ2=29.495,P=0.000)、是否大量吸烟(χ2=9.173,P=0.002)与溃疡的复发明显有关。多因素Logistic分析结果显示,年龄>60岁、BMI>24 kg/m2、女性、有无手术干预、是否穿弹力袜、重体力活动及大量吸烟是下肢静脉溃疡复发的独立风险因素(均P<0.05)。结论:下肢静脉溃疡复发率高,戒烟、减少重体力活动是降低下肢静脉溃疡复发的有效手段,临床上早期手术干预治疗,可减少患者溃疡复发。Background and Aims:Venous leg ulcers are severe complications of chronic venous insufficiency,characterized by high recurrence rates.They can result in prolonged hospitalization,increased financial burden on patients,reduced work capacity,and increased disability.Therefore,this study was performed to identify high-risk factors for the recurrence of venous leg ulcers,providing clinical evidence for effective prevention of ulcer recurrence.Methods:The clinical data of patients with venous leg ulcers treated at Zhongshan Hospital,Xiamen University,from January 2021 to September 2022 were retrospectively analyzed.Univariate and multivariate logistic analyses were performed to identify high-risk factors for ulcer recurrence.Results:A total of 182 patients with venous leg ulcers were included,all of whom received standardized dressing treatment in the chronic wound outpatient department.The recurrence rate of venous leg ulcers was 47.2%.Univariate analysis revealed a significant association between ulcer recurrence and the following factors:surgical intervention(χ2=19.206,P=0.000),use of elastic compression stocking(χ2=23.590,P=0.000),heavy physical activity(χ2=29.495,P=0.000),and heavy smoking(χ2=9.173,P=0.002).Multivariate Logistic analysis showed that age>60 years,BMI>24 kg/m2,female gender,surgical intervention,use of elastic compression stocking,heavy physical activity,and heavy smoking were independent risk factors for the recurrence of venous leg ulcers(all P<0.05).Conclusion:The recurrence rate of venous leg ulcers is high.Smoking cessation and reducing heavy physical labor are effective measures to reduce the recurrence of venous ulcers.Early surgical intervention in clinical practice can decrease ulcer recurrence in patients.

关 键 词：静脉曲张溃疡 复发 危险因素 

分 类 号：R654.3[医药卫生—外科学]