International Institution of Health Care and Additional Education Research Institute of Clinical Medicine, Irkutsk, Russia; Phlebology Department, LLC Vein Center "Antireflux," Surgut, Russia.
Education and Vascular Laboratory, Jobst Vascular Institute, Toledo, Ohio; Division of Vascular Surgery, University of Michigan, Ann Arbor, Mich.
J Vasc Surg Venous Lymphat Disord. 2020 Nov;8(6):1090-1096. doi: 10.1016/j.jvsv.2020.01.005. Epub 2020 Mar 14.
This study investigated the relationship between the ejected blood volume from the calf venous reservoir and the reflux volume (RV) during the automatic cuff inflation-deflation maneuver in limbs with incompetent great saphenous vein.
There were 48 patients with chronic venous disease (C, Е, А, P) included in the study. A noncycling operator-dependent distal cuff inflation-deflation was used as the reflux-provoking maneuver. Duplex ultrasound was used to measure the cross-sectional area of the common femoral vein and great saphenous vein as well as hemodynamic parameters (time-averaged mean velocity and flow duration) of the outflow during cuff inflation and reflux during cuff deflation. The cuff pressure was set at 60, 90, and 120 mm Hg sequentially. The RV flow rate (Q), RV, anterograde ejection volume (EV), and ratio RV/EV (reflux index, IR) were calculated for each pressure setting.
RV correlated with EV and Q (r = 0.366 and r = 0.647, respectively; P < .0001). Q was not significantly different between different cuff inflation pressures. RV and EV were statistically different at different cuff pressure settings (analysis of variance, P < .0001). The IR was almost identical at different pressure settings (0.43 ± 0.23 at 60 mm Hg, 0.43 ± 0.20 at 90 mm Hg, and 0.42 ± 0.19 at 120 mm Hg).
The amount of reflux is primarily determined by the value of EV in a distal cuff compression-decompression maneuver. Both the ratio RV/EV (IR) and RV were related to the severity of the disease, more severe forms having larger IR and RV values.
本研究旨在探讨在大隐静脉功能不全肢体中，自动袖带充气-放气操作过程中从小腿静脉储器中排出的血量与反流量（RV）之间的关系。
本研究纳入了 48 例慢性静脉疾病（C、E、A、P 期）患者。采用非循环操作员依赖的远端袖带充气-放气作为反流诱发操作。使用双功能超声测量股总静脉和大隐静脉的横截面积以及袖带充气过程中的血流动力学参数（平均时均速度和血流持续时间）和袖带放气过程中的反流。袖带压力依次设定为 60、90 和 120mmHg。计算每个压力设置下的 RV 流速（Q）、RV、前向射血体积（EV）和 RV/EV 比值（反流指数，IR）。
RV 与 EV 和 Q 相关（r=0.366 和 r=0.647，均 P<0.0001）。不同袖带充气压力下 Q 无显著差异。不同袖带压力设定下 RV 和 EV 存在统计学差异（方差分析，P<0.0001）。IR 在不同压力设定下几乎相同（60mmHg 时为 0.43±0.23，90mmHg 时为 0.43±0.20，120mmHg 时为 0.42±0.19）。
在远端袖带压缩-减压操作中，反流量主要由 EV 值决定。RV/EV 比值（IR）和 RV 均与疾病严重程度相关，严重程度较高的患者具有较大的 IR 和 RV 值。
