下肢水肿的评估和管理:临床回顾。

Hasan Hazim Alsararatee, Yaseen Hussain, Adnan Adnan
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摘要

下肢水肿是临床上的常见病,经常影响下肢远端。长期久坐或久站等良性原因是典型原因,但水肿也可能预示着严重的全身性疾病,如心力衰竭、肝病或肾功能损害。找出病因对于防止皮肤和组织发生不可逆转的变化至关重要。本临床综述旨在增加高级临床执业医师(ACP)和全科执业医师(包括执业护士和社区护士)的知识,概述如何处理下肢水肿患者,包括病史采集、检查、检验和管理计划。本书的重点在于淋巴水肿,淋巴水肿可以是原发性的,也可以是继发性的。原发性淋巴水肿源于遗传异常,而继发性淋巴水肿则源于肥胖、感染、肿瘤和外伤等因素导致的后天缺陷。有效的治疗方法包括消除潜在病因、确保正确的皮肤护理、建议适当的运动和使用压力衣。必要时,建议将患者转诊至淋巴水肿专科医生处,接受有关管理和治疗淋巴水肿的教育。此外,文章还讨论了定期皮肤检查的重要性、轻微损伤处理、环境因素以及压力衣在淋巴水肿管理中的关键作用。这种全面的方法旨在提高患者的治疗效果,并为全科医生和普通医生提供全面的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing and managing lower limb oedema: a clinical review.

Lower limb oedema is a common condition in clinical practice, frequently affecting the distal lower limbs. Whereas benign causes such as prolonged sitting or standing are typical, oedema can also indicate serious systemic diseases such as cardiac failure, liver disease, or renal impairment. Identifying the cause is crucial to prevent irreversible skin and tissue changes. This clinical review aims to increase the knowledge of advanced clinical practitioners (ACPs) and generalist practitioners, including practice and community nurses, by providing an overview of how to approach patients with lower limb oedema, encompassing history-taking, examinations, investigations, and management plans. The main focus is on lymphoedema, which can be primary or secondary. Primary lymphoedema results from genetic abnormalities, while secondary lymphoedema arises from acquired defects due to factors such as obesity, infections, neoplasms, and trauma. Effective management includes addressing the underlying cause, ensuring proper skin care, recommending appropriate exercises, and the use of compression garments. Referral to a lymphoedema specialist is recommended for patient education on managing and treating the condition when required. Additionally, the article discusses the importance of regular skin inspections, minor injury management, environmental considerations, and the critical role of compression garments in lymphoedema management. This comprehensive approach aims to enhance patient outcomes and provide a thorough strategy for ACPs and generalist practitioners.

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