Vansant J P, Habibian R M, Melton R E
Nuclear Medicine Service, Veterans Administration Medical Center, Nashville, Tennessee.
Clin Nucl Med. 1990 Nov;15(11):783-6. doi: 10.1097/00003072-199011000-00001.
Radionuclide venography (RNV) is an accepted, reliable, and simple method for detecting thrombi of the deep venous system of the lower extremity. No universal agreement, however, has been established regarding specific techniques for tourniquet applications. In fact, present data reflect a general consensus that tourniquet use and location other than above the ankles has no appreciable or recognizable effect on study outcome. A prospective study was performed on 20 consecutive patients referred for RNV with the clinical impression of deep venous thrombosis (DVT). Each patient was studied initially with tourniquets above the knee and ankle, then with tourniquets above the ankle only, and finally without tourniquets. On the basis of standard criteria for DVT, 8 out of 20 patients were positive for DVT when the study was performed with tourniquets only above the ankle. Four of the eight positive studies became negative, however, when additional tourniquets were placed above the knees (20% false-positive rate). It is concluded that the routine application of additional tourniquets above the knees would eliminate a significant number of false-positive studies and should be part of an established routine protocol.
放射性核素静脉造影术（RNV）是一种公认的、可靠且简单的检测下肢深静脉系统血栓的方法。然而，关于止血带应用的具体技术尚未达成普遍共识。事实上，目前的数据反映出一种普遍共识，即止血带在脚踝以上部位的使用和位置对研究结果没有明显或可识别的影响。对20例因临床怀疑深静脉血栓形成（DVT）而转诊进行RNV检查的连续患者进行了一项前瞻性研究。每位患者最初在膝盖和脚踝上方使用止血带进行检查，然后仅在脚踝上方使用止血带进行检查，最后不使用止血带进行检查。根据DVT的标准标准，仅在脚踝上方使用止血带进行检查时，20例患者中有8例DVT呈阳性。然而，在膝盖上方额外放置止血带后，这8例阳性研究中有4例变为阴性（假阳性率为20%）。得出的结论是，在膝盖上方常规应用额外的止血带将消除大量假阳性研究，并且应该成为既定常规方案的一部分。
