Weingarten M S, Branas C C, Czeredarczuk M, Schmidt J D, Wolferth C C
Department of Surgery, Graduate Hospital, University of Pennsylvania, Philadelphia 19146.
J Vasc Surg. 1993 Nov;18(5):753-9.
The purpose of this study was to use color-flow duplex scanning to identify the anatomic distribution of venous reflux and to quantify venous reflux times in patients with various stages of chronic venous insufficiency (CVI).
Color-flow-assisted duplex scanning was used to identify the anatomic distribution of venous reflux and to quantify reflux times in the deep and superficial venous systems of patients with symptomatic (CVI). Two hundred two patients with class I to III CVI were examined.
Only 11% (22 patients) had a documented history of phlebothrombosis. Of the 403 limbs evaluated, 192 had venous ulcers whereas 211 were classified as having class I or II CVI. Nonocclusive venous obstruction was found in only 16 limbs (4%). Venous ulceration was significantly associated with reflux in multiple venous segments as opposed to reflux in isolated venous segments (p < 0.001). Total limb reflux time (Rt) was determined by summing the reflux times of all the venous segments in a limb. The mean Rt of patients with venous ulcerations was significantly longer than the mean Rt of limbs with class I and II CVI (p < 0.01). A total limb reflux time of greater than 9.66 seconds was predictive of ulceration. Total limb deep segment reflux time and total limb superficial segment reflux time were also determined by summing the reflux times of the appropriate segments in the limb. The mean deep segment reflux time was prolonged in limbs with venous ulcers when compared with limbs with class I and II CVI disease. The mean superficial segment reflux time of limbs with class I and II CVI and limbs with venous ulcers could not be used to distinguish between the two groups. In assessing the contribution of segments of the deep system to ulceration, reflux times of different segments were compared with wound duration and area. Reflux in the common femoral vein was significantly associated with wound area and duration (p < 0.05) whereas reflux time in the distal posterior tibial vein was associated with wound duration (p < 0.05).
本研究的目的是使用彩色血流双功扫描来确定静脉反流的解剖分布，并量化不同阶段慢性静脉功能不全（CVI）患者的静脉反流时间。
采用彩色血流辅助双功扫描来确定有症状的（CVI）患者深静脉和浅静脉系统中静脉反流的解剖分布，并量化反流时间。对202例I至III级CVI患者进行了检查。
只有11%（22例患者）有静脉血栓形成的记录病史。在评估的403条肢体中，192条有静脉溃疡，而211条被分类为患有I级或II级CVI。仅在16条肢体（4%）中发现非闭塞性静脉阻塞。与孤立静脉段的反流相比，静脉溃疡与多个静脉段的反流显著相关（p<0.001）。肢体总反流时间（Rt）通过将肢体中所有静脉段的反流时间相加来确定。有静脉溃疡患者的平均Rt显著长于I级和II级CVI肢体的平均Rt（p<0.01）。肢体总反流时间大于9.66秒可预测溃疡形成。肢体总深段反流时间和肢体总浅段反流时间也通过将肢体中相应段的反流时间相加来确定。与I级和II级CVI疾病的肢体相比，有静脉溃疡的肢体平均深段反流时间延长。I级和II级CVI肢体与有静脉溃疡肢体的平均浅段反流时间无法用于区分两组。在评估深静脉系统各段对溃疡形成的作用时，将不同段的反流时间与伤口持续时间和面积进行了比较。股总静脉反流与伤口面积和持续时间显著相关（p<0.05），而胫后静脉远端反流时间与伤口持续时间相关（p<0.05）。
