各种溃疡的鉴别诊断ppt课件.pptx

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1、HowtoDistinguishArterial,VenousandOtherUlcersZhijieXi,MDGuanghuaHospitalAffiliatedtoShanghaiUniversityofTraditionalChineseMedicine1WOUNDTYPES•ARTERIAL(ISCHEMIC)ULCERS•VENOUS(VARICOSE,LEG,STASIS)ULCERS•LYMPHEDEMA(CHRONICDERMALDISRUPTION)ULCERS•PRESSURE(DECUBITUS)ULCERS•LATEEFFECTOFTRAUMA•U

2、NCONTROLLEDINFECTION•AUTOIMMUNEULCERS(PSORIASIS,LUPUS,ETC)2ELEMENTSCOMMONTOMOSTWOUNDSVASCULARCOMPROMISE(ARTERIAL,VENOUS,MICROVASCULAR)•REDUCEDTISSUEOXYGENCONCENTRATION(TCpO2)•METABOLICCOMPROMISE3ARTERIALULCERS4ArterialUlcers5ARTERIALULCERS•Usuallyhavea“punchedout”appearance•Fullthicknessd

3、efect•Mostoftenoccursindiabetics•Maybetheresultofembolic“showering”intothetoes•Canoccuranywhereontheextremities6VENOUSULCERS7VenousUlcers8VENOUSULCERS•Mostoftenaccompanyvaricoseveins•Mostoftenaffectdistallegandankle•Areusuallypainfulandheavilyexudative•Areoftenrecurrent•Exhibitvaryingdept

4、hs,evenwithinthesameulcer•Canbecomehuge9LYMPHEDEMAULCERS10LYMPHEDEMAULCERS•Areinvariablyfoulanddirty•Surroundingskinisindurated•Areheavilyexudative•Canexpandtoencompasstheentirelowerlegandtopofthefoot•Areusuallyinfectedwithmultipleorganismsandyeasts•Occurmostofteninassociationwithobesity1

5、1PRESSUREULCERS12PRESSUREULCERS•Canoccuranywherefollowingsustainedpressure•Canbecomelifethreatening•Areoftenextremelyfoulandinfected13AUTOIMMUNEULCERS14AUTOIMMUNEULCERS•Canmimicotherulcertypes•Areoftencomplicatedwitharterial/venousinsufficiencies•Arecommonwithseverelupus,psoriasisandpemph

6、igoidsyndromes•Arefrequentlyrecurrent15ULCERSOFMIXEDETIOLOGYDIABETICPLANTARULCERBKAPRESSUREULCERDIABETIC/ARTERIALULCERVENOUS/ARTERIALULCER16ULCERSOFMIXEDETIOLOGYPRESSURE/VENOUSULCERVENOUS/ARTERIALULCERPRESSURE/VENOUS/ARTERIALDIABETIC/PRESSUREULCER17CONCLUSIONS•Single-etiologyulcersareunco

7、mmon•Weshouldsuspectarterialinvolvementinanyulcerthatisaccompaniedbydiabetes•Venouslegulcersoftenhaveapressurecomponentand,indiabetics,anarterialcompromise•Anyulcermaybecompromisedinthepresenceofautoimmunediseases18此课件下载可自行编辑修改，供参考！感谢您的支持，我们努力做得更好！