手术治疗后的加压疗法.ppt

手术治疗后的加压疗法 T. Noppeney 我们进行的文献调查： 静脉曲张手术后的加压疗法 Melrose DG, Knight MT, Simandl EThe stripping of varicose veins: a clinical trial of intermittent compression dressings Br J Surg 1979; 66: 53-55 Shouler P, Runchman PVaricose veins: optimum compression after surgery and sclerotherapyAnn Royal Coll Surg Engl 1989; 71: 402-404 Travers JP, Rhodes JE, Hardy JG, Makin GS,Postoperative limb compression in reduction of haemorrhage after varicose vein surgeryAnn R Coll Surg Engl 1993; 75: 119-122 通过99mTc标记的红细胞检测，比较10名患者中高压力弹力绷带和非粘性绉纱对减少静脉曲张术后出血的疗效； 高压力弹力绷带可减少皮下血肿 Houtermans-Auckel JP, van Rossum E, Teigink JA, Eussen EF, Nicolai SP, Welten RJTo wear or not to wear compression stockings after varicose vein stripping: a randomized controlled trialEur J Vasc Endovasc Surg 2009; 38: 387-391 104名患者行大隐静脉反向抽剥术的随机对照临床试验 结果参数：通过光电下肢体积测量评估下肢水肿、疼痛评分、术后并发症 术后4周弹力袜组下肢体积明显减小 (p0,01) 并发症的类型和发生率及疼痛评分无明显区别 Rastel D, Perrin M, Guidicelli MCompressive therapy after varicose vein surgery: results of a French national inquiryJ Mal Vasc 2004; 29: 27-34 675 名外科医生收到问卷; 应答率 41,5 % → 97,1% 在术后使用加压治疗 → 38,8% 行少于8 d 的弹力绷带加压治疗, 24,5% 行8-15 d的弹力绷带加压治疗 → 解除绷带后，12,7%行额外8-15 d的膝上弹力袜加压疗法, 84,6%行额外15-30 d的膝上弹力袜加压疗法 → 总加压疗法时间为 2-6 周 静脉曲张术后行加压疗法 小结 加压疗法对控制术后瘀伤有效 (Grade 1A) 加压疗法减轻术后疼痛 (Grade 1B) 加压疗法减少术后皮下血肿 (Grade 1B) 加压疗法减轻术后下肢肿胀 (Grade 1A) 术后行加压疗法的最佳持续时间尚不清楚 静脉腔内热消融治疗后的加压疗法 静脉腔内热消融治疗后的加压疗法小结 ELA 术后行加压治疗可减轻术后疼痛 (Grade 1A) 无RFO相关的数据资料 硬化剂治疗后的加压治疗 Weiss RA, Sadock NS, Goldman MP, Weiss MAPost-sclerotherapy compression: controlled comparative study of duration of compression and it‘s effects on clinical outcomeDermatol Surg 1999; 25: 105-108 ● 40名患者行加压疗法3天、1周、3周及未行加压疗法的随机对照临床试验 → 毛细血管扩张和网状静脉行硬化剂治疗后行加压疗法可获得更好疗效 → 加压疗法持续时间越长，疗效越好 → 加压疗法可显著减少硬化剂治疗后的皮肤色素沉着 Kern P, Ramelet AA, Wintschert R, Hayon DCompression after sclerotherapy for teleangiectasias and reticular leg veins: a randomized controlled trialJ Vasc Surg 2007; 45: 1212-1215 96例受试者参加的随机对照试验，受试组穿着弹力袜(23-32mm