Nishibe T, Kudo F, Miyazaki K, Kondo Y, Nishibe M, Muto A, Dardik A
Division of Cardiovascular Surgery, Department of Surgery, Fujita Health University, Toyoake, Japan.
Int Angiol. 2008 Oct;27(5):385-8.
We investigated whether parameters of air plethysmography (APG) were correlated with types of superficial venous reflux as categorized by ascending venography in patients with primary varicose veins.
Two hundred and eight limbs with primary varicose veins in 135 patients were evaluated by both APG and ascending venography. Venous hemodynamics was assessed with APG. The location of incompetent vein segments was determined based on the results of ascending venography.
Seventy-seven limbs had incompetence of the greater saphenous vein (GSV, G group), 36 had incompetence of the lesser saphenous vein (LSV, L group), and 77 had incompetence of the GSV and LSV (GL group). Twenty-five limbs did not have incompetence of the GSV or LSV (N group). The venous filling index (VFI) differed significantly between the N and the G and GL groups, the L group and the G and GL groups, and the G and GL groups. No significant difference was found between the N and L groups. The venous volume, ejection fraction, and residual volume fraction did not differ significantly among all four groups.
The VFI as measured by APG discriminates well between limbs with incompetence of the GSV and those without incompetence of the GSV or LSV, and between limbs with incompetence of the GSV and those with the LSV in patients with primary varicose veins, suggesting that the hemodynamic severity of superficial venous reflux progresses with involvement from the LSV to the GSV to both saphenous veins.
我们研究了在原发性静脉曲张患者中,空气体积描记法(APG)的参数与经上行静脉造影分类的浅静脉反流类型之间是否存在相关性。
对135例患者的208条原发性静脉曲张肢体进行了APG和上行静脉造影评估。通过APG评估静脉血流动力学。根据上行静脉造影结果确定功能不全静脉段的位置。
77条肢体存在大隐静脉(GSV)功能不全(G组),36条存在小隐静脉(LSV)功能不全(L组),77条存在GSV和LSV功能不全(GL组)。25条肢体不存在GSV或LSV功能不全(N组)。N组与G组和GL组之间、L组与G组和GL组之间以及G组和GL组之间的静脉充盈指数(VFI)存在显著差异。N组和L组之间未发现显著差异。四组之间的静脉容积、射血分数和残余容积分数无显著差异。
在原发性静脉曲张患者中,通过APG测量的VFI能够很好地区分存在GSV功能不全的肢体与不存在GSV或LSV功能不全的肢体,以及存在GSV功能不全的肢体与存在LSV功能不全的肢体,这表明浅静脉反流的血流动力学严重程度随着累及范围从LSV发展到GSV再到双侧隐静脉而加重。