澳大利亚布鲁斯加略山公立医院Elizabeth Webb团队分析了加压疗法预防腿部蜂窝织炎复发的疗效。2020年8月13日，该研究发表在《新英格兰医学杂志》上。

腿部慢性水肿是蜂窝织炎的危险因素。为了防止蜂窝织炎的复发，有人建议每天在腿上穿加压裤袜，但其有效性仍有待证实。

在这项单中心、随机、非盲试验中，研究组招募了84例患有腿部慢性水肿和复发性蜂窝织炎的参与者，将其按1：1分组，其中41例接受腿部加压疗法以及预防蜂窝织炎的教育（加压组），43例仅接受教育（对照组）。该研究每6个月进行一次随访，最长3年。主要结局是蜂窝织炎的复发。次要结局包括蜂窝织炎相关的入院和生活质量评估。

在计划的中期分析时，共有23例患者蜂窝织炎发作，其中加压组中有6例（15%），对照组中有17例（40%），组间差异显著，试验终止。加压组有3名参与者（7％）因蜂窝织炎住院，对照组有6名（14％），组间差异显著。两组间大多数生活质量结局均无差异。试验期间未发生不良事件。

总之，对于腿部慢性水肿和蜂窝织炎的患者，加压疗法与传统疗法相比，可显著降低蜂窝织炎的复发率。

附：英文原文

Title: Compression Therapy to Prevent Recurrent Cellulitis of the Leg

Author: Elizabeth Webb, M.P.H.,, Teresa Neeman, Ph.D.,, Francis J. Bowden, M.D.,, Jamie Gaida, Ph.D.,, Virginia Mumford, Ph.D.,, and Bernie Bissett, Ph.D.

Issue&Volume: 2020-08-12

Abstract: Abstract

Background

Chronic edema of the leg is a risk factor for cellulitis. Daily use of compression garments on the leg has been recommended to prevent the recurrence of cellulitis, but there is limited evidence from trials regarding its effectiveness.

Methods

In this single-center, randomized, nonblinded trial, we assigned participants with chronic edema of the leg and recurrent cellulitis, in a 1:1 ratio, to receive leg compression therapy plus education on cellulitis prevention (compression group) or education alone (control group). Follow-up occurred every 6 months for up to 3 years or until 45 episodes of cellulitis had occurred in the trial. The primary outcome was the recurrence of cellulitis. Participants in the control group who had an episode of cellulitis crossed over to the compression group. Secondary outcomes included cellulitis-related hospital admission and quality-of-life assessments.

Results

A total of 183 patients were screened, and 84 were enrolled; 41 participants were assigned to the compression group, and 43 to the control group. At the time of a planned interim analysis, when 23 episodes of cellulitis had occurred, 6 participants (15%) in the compression group and 17 (40%) in the control group had had an episode of cellulitis (hazard ratio, 0.23; 95% confidence interval [CI], 0.09 to 0.59; P=0.002; relative risk [post hoc analysis], 0.37; 95% CI, 0.16 to 0.84; P=0.02), and the trial was stopped for efficacy. A total of 3 participants (7%) in the compression group and 6 (14%) in the control group were hospitalized for cellulitis (hazard ratio, 0.38; 95% CI, 0.09 to 1.59). Most quality-of-life outcomes did not differ between the two groups. No adverse events occurred during the trial.

Conclusions

In this small, single-center, nonblinded trial involving patients with chronic edema of the leg and cellulitis, compression therapy resulted in a lower incidence of recurrence of cellulitis than conservative treatment.

DOI: 10.1056/NEJMoa1917197

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1917197