Barros M V L, Labropoulos N, Ribeiro A L P, Okawa R Y, Machado F S
Ecoar-Noninvasive Diagnostic Medicine, Brazil.
Eur J Vasc Endovasc Surg. 2006 Mar;31(3):320-4. doi: 10.1016/j.ejvs.2005.08.017. Epub 2005 Oct 14.
To evaluate anatomical and haemodynamic differences in patients with great saphenous vein (GSV) insufficiency by duplex scanning and air plethysmography.
Duplex scanning and air plethysmography examination were undertaken. One hundred and twenty-one limbs in 91 patients were selected prospectively and divided into three groups: group A consisted of 27 controls; group B consisted of 25 limbs with GSV reflux and normal saphenous femoral junction (SFJ) and group C consisted of 69 limbs of patients with GSV and SFJ reflux. The presence of reflux and GSV diameter (SFJ, proximal and medial thirds of the thigh, the knee and medial and distal thirds of the calf) were assessed by duplex scanning. Air plethysmography was used to evaluate haemodynamic parameters: total venous volume (VV), venous filling index (VFI), residual volume fraction (RVF) and ejection fraction (EF).
There was a significant difference in GSV diameter among the three groups in almost all segments evaluated (e.g. medial thigh group A = 2.4 SD 0.3 mm; B = 3.2 SD 0.7 mm; C = 5.9 SD 2.2mm p<0.001, Anova). A significant difference in VFI was found among the groups (group A = 1.2 SD 0.5; B = 2.0 SD 1.4; C = 4.0 SD 2.5 p<0.05, Anova). VV was statistical different between groups A and C (p = 0.004) and B and C(p = 0.03). EF and RVF were comparable in all groups. The VFI was normal in 68% in group B comparing with only 14.5% in group C patients, finding a reflux more than 5ml/s (determined by VFI) in 26.1% of the group C patients, comparing with only 4% of group B patients (p<0.05).
We have shown that in patients with GSV reflux those with incompetence of the ostial valve of the GSV show greater venous reflux and dilatation of the saphenous trunk than those in whom the ostial valve is competent.
通过双功超声扫描和空气容积描记法评估大隐静脉（GSV）功能不全患者的解剖学和血流动力学差异。
进行双功超声扫描和空气容积描记法检查。前瞻性选取91例患者的121条肢体，分为三组：A组为27例对照；B组为25条大隐静脉反流但隐股交界处（SFJ）正常的肢体；C组为69条大隐静脉及隐股交界处反流患者的肢体。通过双功超声扫描评估反流情况及大隐静脉直径（隐股交界处、大腿近端和中1/3、膝关节以及小腿内侧和远1/3）。使用空气容积描记法评估血流动力学参数：总静脉容量（VV）、静脉充盈指数（VFI）、残余容量分数（RVF）和射血分数（EF）。
在几乎所有评估节段中，三组间大隐静脉直径存在显著差异（例如，大腿内侧：A组 = 2.4±0.3mm；B组 = 3.2±0.7mm；C组 = 5.9±2.2mm，p<0.001，方差分析）。各组间VFI存在显著差异（A组 = 1.2±0.5；B组 = 2.0±1.4；C组 = 4.0±2.5，p<0.05，方差分析）。A组与C组之间以及B组与C组之间VV存在统计学差异（p = 0.004和p = 0.03）。各组间EF和RVF具有可比性。B组中68%的患者VFI正常，而C组患者中仅14.5%正常，C组26.1%的患者反流超过5ml/s（由VFI确定），而B组患者中仅4%（p<0.05）。
我们已经表明，在大隐静脉反流患者中，大隐静脉瓣膜口功能不全者比瓣膜口功能正常者表现出更大的静脉反流和大隐静脉主干扩张。
