Neglén P, Raju S
River Oaks Hospital, Jackson, MS, USA.
J Vasc Surg. 2000 Nov;32(5):894-901. doi: 10.1067/mva.2000.110351.
The purpose of this study was to examine the relationship among pressures obtained simultaneously in the popliteal, long saphenous, and dorsal foot veins.
Eight limbs were studied. One limb had an isolated popliteal vein reflux, and two had moderate long saphenous vein incompetence. No perforator or short saphenous vein insufficiency was detected. Pressures and recovery times of the popliteal/tibial and long saphenous veins were obtained with cannulation at the ankle level and insertion of catheters with a pressure transducer tip. The dorsal foot vein pressure was measured with the insertion of a scalp needle (14-gauge) connected to an external transducer. During 10 toe stands, recordings were simultaneously made in the three veins at the level of the knee joint, in the middle third of the calf, and 5 to 7 cm above the ankle with all the transducers at the same level (ie, same reference point).
In one limb the popliteal/tibial pressure increased at all calf levels, whereas pressures decreased in both saphenous and dorsal foot veins. The pressures decreased in all three systems in the remaining seven limbs. There was no statistical difference between the pressure drop in the long saphenous vein and the deep vein. However, the decrease of the dorsal foot venous pressure was significantly more marked compared with the other two veins at all levels. The recovery time was significantly increased in the long saphenous vein compared with the deep vein; recovery time was further prolonged in the dorsal foot vein.
The dorsal foot, long saphenous, and popliteal/posterior tibial veins clearly exhibit different pressure waveforms in response to calf exercise. The postexercise pressure, the percentage pressure drop, and the recovery times are widely different, which indicates that the three veins behave hydraulically as separate compartments in limbs without significant venous insufficiency.
本研究旨在探讨腘静脉、大隐静脉和足背静脉同时测得的压力之间的关系。
对8条肢体进行研究。其中1条肢体存在孤立性腘静脉反流，2条存在中度大隐静脉功能不全。未检测到穿通静脉或小隐静脉功能不全。通过在踝关节水平插管并插入带有压力传感器尖端的导管，获取腘静脉/胫静脉和大隐静脉的压力及恢复时间。通过插入连接外部传感器的头皮针（14号）测量足背静脉压力。在10次踮脚尖动作过程中，使用处于同一水平（即相同参考点）的所有传感器，在膝关节水平、小腿中1/3以及踝关节上方5至7厘米处同时记录三条静脉的情况。
在1条肢体中，腘静脉/胫静脉压力在小腿各水平均升高，而大隐静脉和足背静脉压力均下降。在其余7条肢体中，三条静脉系统的压力均下降。大隐静脉压力下降与深静脉之间无统计学差异。然而，在所有水平上，足背静脉压力下降均明显比其他两条静脉更显著。与深静脉相比，大隐静脉的恢复时间显著延长；足背静脉的恢复时间进一步延长。
足背静脉、大隐静脉以及腘静脉/胫后静脉在小腿运动时明显呈现出不同的压力波形。运动后压力、压力下降百分比以及恢复时间差异很大，这表明在没有明显静脉功能不全的肢体中，这三条静脉在液压方面表现为独立的腔室。
