Fukuoka M, Okada M, Sugimoto T
Department of Surgery, Division II, Kobe University School of Medicine, Japan.
Br J Surg. 1999 Sep;86(9):1149-54. doi: 10.1046/j.1365-2168.1999.01214.x.
Measurement of foot venous pressure (FVP) is useful for evaluating chronic venous insufficiency (CVI) functionally, because CVI always causes venous hypertension. In the present study, the various FVP parameters were analysed according to the new classification of venous disorders based on clinical, aetiological, anatomical and pathophysiological data (the CEAP classification).
During the past 7 years, a total of 257 legs in 196 consecutive patients with CVI have been studied. The following FVP parameters were assessed: the percentage decrease in pressure from rest with manual calf compression, the rate of increase of pressure during 4 s after compression (4SR) and the time to 50 per cent recovery of pressure (RT50) after release of compression.
The incidence of skin changes due to venous stasis increased as the percentage pressure drop and RT50 fell. In addition, a pressure drop of less than 72 per cent and an RT50 of less than 20 s could detect legs with skin changes with a sensitivity of 76 per cent and a specificity of 62 per cent. In legs with primary varicose veins, pressure drop, 4SR and RT50 values deteriorated in proportion to the severity of the associated deep venous reflux.
FVP parameters correlate well with the severity of clinical manifestations and venous reflux, and could be used quantitatively to evaluate the severity of CVI.
足部静脉压(FVP)测量对于从功能上评估慢性静脉功能不全(CVI)很有用,因为CVI总是导致静脉高压。在本研究中,根据基于临床、病因、解剖和病理生理数据的静脉疾病新分类(CEAP分类),对各种FVP参数进行了分析。
在过去7年中,对196例连续的CVI患者的257条腿进行了研究。评估了以下FVP参数:手动压迫小腿后静息时压力下降的百分比、压迫后4秒内压力增加的速率(4SR)以及压迫解除后压力恢复到50%所需的时间(RT50)。
由于静脉淤滞导致的皮肤变化发生率随着压力下降百分比和RT50的降低而增加。此外,压力下降小于72%且RT50小于20秒可检测出有皮肤变化的腿,其敏感性为76%,特异性为62%。在原发性静脉曲张的腿中,压力下降、4SR和RT50值与相关深静脉反流的严重程度成比例恶化。
FVP参数与临床表现和静脉反流的严重程度密切相关,可用于定量评估CVI的严重程度。