Sethia K K, Darke S G
Br J Surg. 1984 Oct;71(10):754-5. doi: 10.1002/bjs.1800711006.
Four hundred and seventeen consecutive patients referred with significant chronic venous disorders of the lower limb have been studied. Two hundred and ninety-nine were considered to have uncomplicated primary varicose veins, with saphenous incompetence. The remaining 118 presented with past or current skin ulceration, prominent pain and swelling, or both. Ascending and descending venography and further Doppler studies revealed only 18 patients (17 with ulceration) with an incompetent long saphenous system and ankle perforators as the only identifiable abnormalities. In 12 of these, patients' dorsal foot vein pressures were measured at rest and the maximum fall demonstrable after exercise expressed as a percentage of this (12.9 per cent +/- 6.0). This test was repeated with a narrow tourniquet inflated to 160 mmHg, applied to the mid-thigh (35.6 per cent +/- 7.4) (P less than 0.05), and again after accurate groin ligation and stripping of the long saphenous vein to the knee (31.9 per cent +/- 10.7) (P less than 0.05). These results seem to validate the use of the foot pressure/tourniquet test in assessing the relevance of saphenofemoral incompetence, and suggest in a proportion of venous ulcers this is a princical factor.
对417例因严重下肢慢性静脉疾病前来就诊的连续患者进行了研究。其中299例被认为患有单纯性原发性静脉曲张，伴有大隐静脉功能不全。其余118例有既往或当前的皮肤溃疡、明显疼痛和肿胀，或两者皆有。上行和下行静脉造影以及进一步的多普勒研究仅发现18例患者（17例有溃疡）存在大隐静脉系统功能不全和踝部穿通支功能不全，这是唯一可识别的异常情况。在其中12例患者中，测量了静息时的足背静脉压力以及运动后可显示的最大压力下降，并以其百分比表示（12.9%±6.0）。使用充气至160 mmHg的窄止血带绑在大腿中部重复进行该测试（35.6%±7.4）（P<0.05），在准确结扎腹股沟并剥脱至膝关节的大隐静脉后再次进行测试（31.9%±10.7）（P<0.05）。这些结果似乎证实了足压/止血带测试在评估股隐静脉功能不全相关性方面的应用价值，并表明在一部分静脉溃疡病例中，这是一个主要因素。
