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不同长度和压力梯度的梯度压缩弹力袜联合踝泵运动对股静脉血流速度的比较:一项初步研究。

The comparison of graduated compression stockings of different length and pressure gradients combined with ankle pump movement on femoral vein blood velocity: a pilot study.

机构信息

Department of Ultrasound, China-Japan Friendship Hospital, Beijing, China.

National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Clinical Research and Data Management, Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.

出版信息

Int Angiol. 2023 Jun;42(3):239-246. doi: 10.23736/S0392-9590.23.04944-1. Epub 2023 Feb 16.

Abstract

BACKGROUND

Graduated compression stocking (GCS) is one the most widely used intervention methods in decreasing venous stasis and preventing deep venous thrombosis in hospital patients. However, changes of femoral vein speed after using GCS, combining ankle pump movement or not, and the efficacy difference of GCS among brands are still unclear.

METHODS

In this single-center cross-sectional study, healthy participants were assigned to wear one of the three different GCSs (type A, B and C) on both legs. Type B was with lower compressions at popliteal fossa, middle thigh and upper thigh, compared with type A and C. Blood flow velocity of femoral veins was measured with a Doppler ultrasound scanner in the following four conditions: Lying, ankle pump movement, wearing GCS, and GCS combining ankle pump movement. The differences of femoral vein velocity between conditions in each GCS type, and differences of femoral vein velocity changes between GCS type B and type C were compared, respectively.

RESULTS

A total of 26 participants enrolled and 6 wore type A, 10 wore type B and 10 wore type C GCS. Compared with lying, participants wearing type B GCS had significant higher left femoral vein peak velocity (PVL) and left femoral vein trough velocity (TVL) (absolute difference [AD] 10.63, 95% confidence interval [95% CI] 3.17-18.09, P=0.0210; AD 8.65, 95% CI: 2.84-14.46, P=0.0171, respectively). Compared with ankle pump movement only, TVL significantly increased in participants wearing type B GCS and so did right femoral vein trough velocity (TVR) in in participants wearing type C GCS. Comparing with lying, the AD of PVL was significantly higher in participants wearing type B GCS than those wearing type C GCS (10.63±12.03 vs. -0.23±8.89, P<0.05).

CONCLUSIONS

GCS with lower compressions at popliteal fossa, middle thigh and upper thigh was related with higher femoral vein velocity. Femoral vein velocity of left leg increased much more than that of right leg in participants wearing GCS with/without ankle pump movement. Further investigations are needed to translate the herein reported hemodynamic effect of different compression dosages into a potentially different clinical benefit.

摘要

背景

梯度压力弹力袜(GCS)是一种广泛应用于降低静脉淤滞和预防住院患者深静脉血栓形成的干预方法。然而,使用 GCS 后股静脉速度的变化、是否结合踝泵运动以及不同品牌 GCS 的疗效差异仍不清楚。

方法

本单中心横断面研究将健康参与者分配到双腿上穿着三种不同 GCS(A型、B 型和 C 型)中的一种。与 A 型和 C 型相比,B 型在腘窝、大腿中部和大腿上部的压缩力较低。使用多普勒超声扫描仪在以下四种情况下测量股静脉血流速度:卧位、踝泵运动、穿着 GCS 和 GCS 结合踝泵运动。比较了每种 GCS 类型中股静脉速度在不同条件之间的差异,以及 GCS 类型 B 和 C 之间股静脉速度变化的差异。

结果

共纳入 26 名参与者,其中 6 名穿着 A 型,10 名穿着 B 型,10 名穿着 C 型 GCS。与卧位相比,穿着 B 型 GCS 的参与者的左股静脉峰值速度(PVL)和左股静脉低谷速度(TVL)明显更高(绝对差值 [AD] 10.63,95%置信区间 [95%CI] 3.17-18.09,P=0.0210;AD 8.65,95%CI:2.84-14.46,P=0.0171)。与仅踝泵运动相比,穿着 B 型 GCS 的参与者的 TVL显著增加,而穿着 C 型 GCS 的参与者的右股静脉低谷速度(TVR)也增加。与卧位相比,穿着 B 型 GCS 的参与者的 PVLAD 明显高于穿着 C 型 GCS 的参与者(10.63±12.03 与-0.23±8.89,P<0.05)。

结论

腘窝、大腿中部和大腿上部压缩力较低的 GCS 与更高的股静脉速度相关。在穿着 GCS 进行/不进行踝泵运动的参与者中,左股静脉速度的增加明显高于右股静脉速度的增加。需要进一步的研究将此处报道的不同压缩剂量的血液动力学效应转化为潜在的不同临床获益。

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