[静脉反流：因体位差异导致的测量变异性]

[Venous reflux: Measurement variability due to positional differences].

作者信息

Mahmutyazicioğlu Kamran, Gündoğdu Sadi, Ozdemir Hüseyin, Savranlar Ahmet, Asil Kiyasettin

机构信息

Zonguldak Karaelmas Universitesi Tip Fakültesi, Radyodiagnostik Anabilim Dali, Kozlu, Zonguldak.

出版信息

Tani Girisim Radyol. 2003 Dec;9(4):471-5.

PMID:14730959

Abstract

PURPOSE

The purpose of this study was to evaluate the role of the subject's position and two different maneuvers in the reflux measurements in femoral veins.

MATERIALS AND METHODS

Venous reflux times in the common femoral vein (CFV) and superficial femoral vein (SFV) were studied in 50 healthy subjects (25 women, 25 male) aged between 22-57 years-old while the subjects were in supine and standing positions. Reflux was provocated only by Valsalva maneuver (VM) when the subject was lying down, whereas it was provocated by (1) Valsalva maneuver and (2) compression and release maneuver, respectively, when the subject was standing. Reflux times were recorded with each of the three methods.

RESULTS

Regarding CFV, a reflux time of 1 second or more was recorded in 29 limbs (29%) only in the supine position. Of these 29 measurements, 19 were between 1 and 1.9 sec and 8 between 2 and 2.9 sec. When the subjects were examined in the standing position, the prevalence of reflux lasting more than 1 sec substantially decreased (5%). The prevalence of reflux lasting less than 0.5 sec was 97% with standing compression maneuver, 84% with standing VM and 27% with supine VM. Similarly, prevalence of reflux of longer than 0.5 sec or 1 sec was lower in the standing position than in the supine position in SFV. In CFV, mean reflux time was 1.3 sec in the supine position, whereas it was 0.7 sec and 0.4 sec with standing compression and standing Valsalva maneuvers, respectively. Corresponding values in SFV were 0.5 sec, 0.3 sec and 0.2 sec, respectively.

CONCLUSION

The probability of making a false positive diagnosis of pathological reflux is high with supine examinations. When an examination in the supine position reveals a reflux time of longer than 1 second, making the patient stand up is expected to yield more reliable results. Compression and release maneuver, with its lowest false positive reflux prevalence, is the most reliable method in the evaluation of venous insufficiency.

摘要

目的

本研究旨在评估受试者体位及两种不同手法在股静脉反流测量中的作用。

材料与方法

对50名年龄在22至57岁之间的健康受试者（25名女性，25名男性）进行股总静脉（CFV）和股浅静脉（SFV）的静脉反流时间研究，受试者分别处于仰卧位和站立位。当受试者仰卧时，仅通过瓦尔萨尔瓦动作（VM）诱发反流；而当受试者站立时，分别通过（1）瓦尔萨尔瓦动作和（2）压迫与松开动作诱发反流。用这三种方法分别记录反流时间。

结果

关于CFV，仅在仰卧位时，29条肢体（29%）记录到反流时间为1秒或更长。在这29次测量中，19次在1至1.9秒之间，8次在2至2.9秒之间。当受试者站立位检查时，持续超过1秒的反流发生率大幅下降（5%）。站立位压迫动作时，持续时间小于0.5秒的反流发生率为97%，站立位VM时为84%，仰卧位VM时为27%。同样，在SFV中，站立位时持续超过0.5秒或1秒的反流发生率低于仰卧位。在CFV中，仰卧位时平均反流时间为1.3秒，而站立位压迫动作和站立位瓦尔萨尔瓦动作时分别为0.7秒和0.4秒。SFV中的相应值分别为0.5秒、0.3秒和0.2秒。