Fozard J B, Wilkinson D, Parkin A, Kester R C
St James's University Hospital, Leeds.
Ann R Coll Surg Engl. 1990 Jan;72(1):45-8.
A new method of limb blood flow measurement has been developed; normal flow is 10-22 ml/100 ml of tissue/min and flow to limbs with claudication is 1.8-2.3. Does this technique help to deal with diagnostic problems in vascular surgery? Twenty-five patients presented with exercise-induced leg pain. Twelve had a convincing history of claudication but seven of these had palpable pedal pulses, the other five had normal Doppler ratios. Of 13 with a poor history six had absent pulses; of the other seven with palpable pulses, two had abnormal and five had normal Doppler ratios. All 25 patients have had blood flow to both legs measured. For the five with a poor history, palpable pulses and normal Doppler ratios: (Table: see text). Twelve had reduced flows consistent with claudication (less than 8 ml/100 ml of tissue/min); 10 of these have undergone arteriography which demonstrated significant vascular disease, one had surgery to rheumatoid toes deferred and one refused further investigation. Of 13 with normal flows nine have been found to have significant orthopaedic problems affecting spine, hips or knees, the other four have all had normal arteriograms. In every case the history, signs or Doppler ratios were potentially misleading, but all cases of significant arterial disease were detected. It is cheap, readily available and effectively selected cases for referral or arteriography.
一种测量肢体血流的新方法已被开发出来；正常血流量为10 - 22毫升/100毫升组织/分钟，而间歇性跛行肢体的血流量为1.8 - 2.3。这项技术有助于解决血管外科的诊断问题吗？25名患者表现为运动诱发的腿痛。12名患者有令人信服的间歇性跛行病史，但其中7名可触及足背脉搏，另外5名患者的多普勒比值正常。在13名病史不典型的患者中，6名脉搏消失；在另外7名可触及脉搏的患者中，2名多普勒比值异常，5名正常。所有25名患者均测量了双腿的血流。对于5名病史不典型、可触及脉搏且多普勒比值正常的患者：（表格：见原文）。12名患者的血流量降低，符合间歇性跛行（低于8毫升/100毫升组织/分钟）；其中10名患者接受了动脉造影，显示有明显的血管疾病，1名患者因类风湿性脚趾问题推迟了手术，1名患者拒绝进一步检查。在13名血流量正常的患者中，9名被发现有影响脊柱、髋部或膝盖的严重骨科问题，另外4名患者的动脉造影均正常。在每种情况下，病史、体征或多普勒比值都可能产生误导，但所有严重动脉疾病的病例都被检测出来了。它价格便宜，易于操作，能有效地筛选出适合转诊或进行动脉造影的病例。
