Kalodiki E, Calahoras L S, Delis K T, Zouzias C P, Nicolaides A N
Irvine Laboratory for Cardiovascular Investigation and Research, Division of Surgery, Anesthetics, and Intensive Care, Imperial College School of Medicine, St Mary's Hospital, London, UK.
J Vasc Surg. 2001 Apr;33(4):715-20. doi: 10.1067/mva.2001.111743.
In this study we assessed the accuracy of air plethysmography (APG) as a means of detecting earlier deep venous thrombosis (DVT), in comparison with venography, to develop a preoperative test for patients with varicose veins.
In this retrospective analysis of prospectively acquired data, 202 patients referred with the clinical suspicion of chronic venous obstruction (224 lower limbs) and 41 patients (41 lower limbs) who had symptoms and signs suggestive of DVT, but had deep veins that appeared normal on venography, were studied with both venography and APG.
The results of venography were negative for past DVT in 169 legs and confirmed past DVT in 96 limbs. The DVTs were confined to the calf in 19 limbs and were found at popliteal level, more proximal, or both in 77 limbs. A total of 95% of the limbs that had earlier proximal DVT (73 of 77) were identified by means of an APG outflow fraction with occlusion of the superficial veins in the first second (OFs) of less than 28%. This is analogous to the Q wave of the electrocardiogram, which is a means of denoting the presence of myocardial infarction. The specificity rate of the method in the detection of past proximal DVT was 96%, the positive predictive value was 92%, and the negative predictive value was 98%.
APG is a practical, inexpensive, easy-to-perform, accurate, noninvasive method for the diagnosis of hemodynamically significant (ie, proximal or extensive calf DVT) chronic venous obstruction that could replace venography.
在本研究中，我们评估了空气体积描记法（APG）作为一种检测早期深静脉血栓形成（DVT）的方法的准确性，并与静脉造影术进行比较，以开发一种针对静脉曲张患者的术前检查方法。
在这项对前瞻性收集数据的回顾性分析中，对202例临床怀疑有慢性静脉阻塞的患者（224条下肢）以及41例有DVT症状和体征但静脉造影显示深静脉正常的患者（41条下肢）进行了静脉造影和APG检查。
静脉造影结果显示，169条腿既往DVT为阴性，96条肢体证实有既往DVT。DVT局限于小腿的有19条肢体，在腘静脉水平、更靠近近端或两者均有的有77条肢体。共有95%的既往近端DVT肢体（77条中的73条）可通过APG流出分数来识别，即浅静脉在第1秒和第2秒闭塞时的流出分数（OFs）小于28%。这类似于心电图的Q波，是表示心肌梗死存在的一种方式。该方法检测既往近端DVT的特异性率为96%，阳性预测值为92%，阴性预测值为98%。
APG是一种实用、廉价、易于操作、准确的非侵入性方法，可用于诊断血流动力学显著的（即近端或广泛小腿DVT）慢性静脉阻塞，有望取代静脉造影术。
