van Geest A J, Veraart J C, Nelemans P, Neumann H A
Department of Dermatology, Academisch Ziekenhuis Maastricht, Maastricht, The Netherlands.
Dermatol Surg. 2000 Mar;26(3):244-7. doi: 10.1046/j.1524-4725.2000.09200.x.
Medical elastic compression stockings are widely used in venous diseases. Their effects on the venous system have been shown in the past. Up to now, little is known about the slope or stiffness factor of stockings.
To evaluate the effect of different slope and stiffness factors of medical elastic compression stockings on the venous system.
Examinations were carried out in 29 legs of 25 different patients (12 men, 13 women) with a mean age of 66.0 years. All patients were known with chronic venous insufficiency. On all these patients three different elastic medical compression stockings were tested; one with a low slope, one with a high slope, and one with a low slope but a higher pressure at the ankle. The tests were carried out by determining capillary filtration rate (CFR) with air-plethysmography (APG) while wearing the stockings.
The mean value of the CFR without wearing a stocking was 4.65 ml/min (SD = 1.68), with Compriform (low slope, 30 mmHg) the mean CFR was 3.54 ml/min (SD = 1.22), with Bellavar (high slope, 30 mmHg) a mean CFR of 3.15 ml/min (SD = 1.17) was found, and the mean CFR related to Fast-fit (low slope, 34.5 mmHg) was 3.02 ml/min (SD = 1.12). There is a highly statistically significant difference in CFR between no stockings and wearing a stocking (paired Student's t-test; P < 0.01). Regarding the individual stocking, there is a highly statistically significant difference in CFR between the Compriform and the other two stockings (paired Student's t-test; P < 0.01). Between Bellavar and the Fast-fit the difference was not statistically significant.
There is a statistically significant difference in CFR, and consequently in the development of edema, between not wearing an elastic compression stocking and wearing an elastic compression stocking. There is also a statistically significant difference in CFR between elastic compression stockings with the same compression, but a low slope profile and a high slope profile. Stockings with a low slope, but a higher compression may perform as well as stockings with a higher slope but a lower compression in reducing the CFR. In patients with a strong tendency to develop edema it may be advisable to prescribe stockings with a high slope profile.
医用弹性加压袜广泛应用于静脉疾病。过去已证实其对静脉系统的作用。到目前为止,对于袜子的斜率或硬度因素了解甚少。
评估医用弹性加压袜不同斜率和硬度因素对静脉系统的影响。
对25例不同患者(12例男性,13例女性)的29条腿进行检查,平均年龄66.0岁。所有患者均患有慢性静脉功能不全。对所有这些患者测试了三种不同的弹性医用加压袜;一种低斜率,一种高斜率,一种低斜率但脚踝处压力较高。测试通过在穿着袜子时用空气容积描记法(APG)测定毛细血管滤过率(CFR)来进行。
不穿袜子时CFR的平均值为4.65 ml/min(标准差=1.68),使用Compriform(低斜率,30 mmHg)时CFR的平均值为3.54 ml/min(标准差=1.22),使用Bellavar(高斜率,30 mmHg)时发现CFR的平均值为3.15 ml/min(标准差=1.17),与Fast-fit(低斜率,34.5 mmHg)相关的CFR平均值为3.02 ml/min(标准差=1.12)。不穿袜子和穿袜子时CFR之间存在高度统计学显著差异(配对t检验;P<0.01)。就单个袜子而言,Compriform与其他两种袜子之间CFR存在高度统计学显著差异(配对t检验;P<0.01)。Bellavar和Fast-fit之间的差异无统计学意义。
不穿弹性加压袜和穿弹性加压袜之间,CFR存在统计学显著差异,因此在水肿形成方面也存在差异。在相同压力但低斜率和高斜率的弹性加压袜之间,CFR也存在统计学显著差异。低斜率但较高压力的袜子在降低CFR方面可能与高斜率但较低压力的袜子表现相同。对于有强烈水肿倾向的患者,建议开具高斜率的袜子。