Partsch Bernhard, Partsch Hugo
J Vasc Surg. 2005 Oct;42(4):734-8. doi: 10.1016/j.jvs.2005.06.030.
Compression therapy needs to narrow the veins of patients with venous disorders to achieve a hemodynamic effect. This study investigated the external pressure necessary to narrow and occlude leg veins in different body positions.
In nine healthy volunteers and five patients with incompetent small saphenous veins, the diameter of the small saphenous veins and of one posterior tibial vein was measured at the mid level of the calf by duplex ultrasound scans in sitting, standing, and supine positions. A modified blood pressure cuff with an acetate window that permitted ultrasound visualization of the veins was gradually inflated, and the pressures needed to narrow or occlude the veins were recorded.
Initial narrowing occurs with a median pressure of between 30 and 40 mm Hg in the sitting and standing positions. Complete occlusion of superficial and deep leg veins occurs with 20 to 25 mm Hg in the supine position, between 50 and 60 mm Hg in the sitting position, and at about 70 mm Hg in the standing position. The difference between sitting and standing, and between standing and supine, was statistically significant (P < .01 and P < .001, respectively).
The external pressure has to exceed the hydrostatic pressure in the vein to compress leg veins effectively. Higher external pressures than can be expected to be delivered by elastic compression stockings are required to achieve the collapse of lower-extremity veins in the upright position.
压迫疗法需要使静脉疾病患者的静脉变窄以达到血液动力学效应。本研究调查了在不同体位下使腿部静脉变窄和闭塞所需的外部压力。
对9名健康志愿者和5名小隐静脉功能不全的患者，通过双功超声扫描在小腿中部测量他们在坐位、站立位和仰卧位时小隐静脉及一条胫后静脉的直径。使用带有醋酸盐窗口（可使超声观察静脉）的改良血压袖带逐渐充气，并记录使静脉变窄或闭塞所需的压力。
在坐位和站立位时，初始变窄发生的中位压力在30至40毫米汞柱之间。在仰卧位时，腿部浅静脉和深静脉在20至25毫米汞柱时完全闭塞，在坐位时为50至60毫米汞柱，在站立位时约为70毫米汞柱。坐位与站立位之间以及站立位与仰卧位之间的差异具有统计学意义（分别为P <.01和P <.001）。
外部压力必须超过静脉中的静水压力才能有效压迫腿部静脉。在直立位时，要使下肢静脉塌陷，需要比弹性压迫袜预期提供的更高外部压力。
