Evers E J, Wuppermann T
Department of Angiology, Klinikum Darmstadt, Germany.
Vasa. 1999 Feb;28(1):19-23. doi: 10.1024/0301-1526.28.1.19.
Reflux in deep veins is an important pathophysiological factor of post-thrombotic syndrome which can be demonstrated by colour-coded duplexsonography. This study investigates the effect of different compression therapies on the reflux velocity in deep veins in patients with a post-thrombotic syndrome.
Sixty patients with a post-thrombotic syndrome-confirmed by phlebography, in the deep veins of the calf and the thigh were investigated in two groups: In group A, 30 patients (mean age 58 +/- 10 years) received compression stockings (calf compression class II and III, thigh compression class II) and in group B 30 patients (mean age 58 +/- 14 years) received a Sigg short traction bandage of the calf. The velocity at the time of the greatest reflux in the popliteal vein was determined as reflux parameter with the colour-coded duplex sonography using a cuff applied at the calf. All patients stood upright and were measured with and without different kinds of compression therapies. The reflux velocities were graded as low, moderate and high.
A significant decrease of the reflux velocity by about more than 45% with compression therapy was found in both groups. The decrease of the refluxes in group A (mean 47.9%) did not differ significantly from the decrease of refluxes in group B (mean 55.8%). The greatest decrease of the reflux velocity under compression therapy was found in high-grade refluxes in both groups.
A significant decrease of the reflux velocity in post-thrombotic syndrome can be readily demonstrated with different kinds of compression stockings as well as with bandages by means of colour-coded duplex sonography.
深静脉反流是血栓形成后综合征的一个重要病理生理因素,可通过彩色编码双功能超声检查显示。本研究调查了不同压迫疗法对血栓形成后综合征患者深静脉反流速度的影响。
60例经静脉造影确诊为血栓形成后综合征的患者,其小腿和大腿的深静脉被分为两组进行研究:A组30例患者(平均年龄58±10岁)使用弹力袜(小腿压迫等级为II级和III级,大腿压迫等级为II级),B组30例患者(平均年龄58±14岁)使用小腿Sigg短牵引绷带。使用彩色编码双功能超声检查,通过在小腿处应用袖带,将腘静脉最大反流时的速度确定为反流参数。所有患者站立,在使用和不使用不同类型压迫疗法的情况下进行测量。反流速度分为低、中、高三个等级。
两组患者在接受压迫治疗后,反流速度均显著降低约45%以上。A组反流速度的降低(平均47.9%)与B组反流速度的降低(平均55.8%)差异无统计学意义。两组中,压迫治疗下反流速度降低最大的是高度反流患者。
通过彩色编码双功能超声检查可以很容易地证明,使用不同类型的弹力袜和绷带对血栓形成后综合征患者的反流速度有显著降低作用。