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身體活動對下肢靜脈性潰瘍傷口之癒合成效

Effectiveness of Physical Activity on the Wound Healing among Patients with Venous Leg Ulcer

摘要


慢性靜脈功能不全症會造成下肢靜脈性潰瘍(venous leg ulcers, VLUs)。然而,慢性靜脈功能不全症引起的靜脈高壓,會導致小腿肌肉幫浦與踝關節功能降低,故陸續有研究探討,介入身體活動提高小腿肌肉幫浦與踝關節功能,促進傷口癒合的可行性。本研究目的即選取已發表的隨機對照試驗進行系統性文獻回顧,藉以統合身體活動介入VLUs傷口癒合成效之實證。搜尋台灣期刊論文引索、Cochrane Library、PubMed、CINAHL(EBSCO)及ProQuest Nursing Allied Health至2020年4月7日發表的中英文文獻,最後共得9篇研究。研究結果發現介入身體活動之步行、踝關節背屈活動、腿抬高、深蹲和有氧運動,在VLUs病人的傷口癒合都有不錯的成效,建議可將身體活動列為下肢靜脈性潰瘍照護的輔助治療,但未來仍需大型嚴謹的研究繼續驗證。

並列摘要


Chronic venous insufficiency can cause venous leg ulcers (VLUs), and the venous hypertension caused by chronic venous insufficiency will decrease the functions of the calf muscle pump and ankle joint. Therefore, physical activities may be feasible to improve the function of calf muscle pump and ankle joint, and to promote wound healing. This study aimed to perform a systematic review of randomized controlled trials to summarize the effects of physical activity on the wound healing among patients with VLUs. This review focused on studies published before April 7, 2020 and included searches of the following databases: Taiwan Journal Article Index, Cochrane Library, PubMed, CINAHL (EBSCO), and ProQuest Nursing Allied Health. Nine studies met the inclusion criteria. The results of the studies found that the physical activities of walking, ankle dorsiflexion, leg elevation, squats and aerobic exercise have good results on VLUs wound healing. It is recommended that physical activity can be listed as an auxiliary to the care of VLUs patients. However, a large and meticulous study is still needed to verify the effectiveness in the future.

參考文獻


Qiao T, Liu C, Ran F. The impact of gastrocnemius muscle cell changes in chronic venous insufficiency. Eur J Vasc Endovasc Surg 2005;30:430-6.
van Uden CJ, van der Vleuten CJ, Kooloos JG, et al. Gait and calf muscle endurance in patients with chronic venous insufficiency. Clin Rehabil 2005;19:339-4.
Heinen MM, Bartholomew LK, Wensing M, et al. Supporting adherence and healthy lifestyles in leg ulcer patients:Systematic development of the Lively Legs program for dermatology outpatient clinics. Patient Educ Couns 2006;61:279-91.
Guest JF, Fuller GW, Vowden P. Venous leg ulcer management in clinical practice in the UK: Costs and outcomes. Int Wound J 2018;15:29-37.
Vlajinac H, Marinkovic J, Maksimovic M, et al. Factors related to venous ulceration: A cross-sectional study. Angiology 2014;65:824-30.

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