Rodriguez A A, Whitehead C M, McLaughlin R L, Umphrey S E, Welch H J, O'Donnell T F
Department of Surgery, Tufts University School of Medicine, Boston, MA 02111, USA.
J Vasc Surg. 1996 Apr;23(4):606-10. doi: 10.1016/s0741-5214(96)80039-5.
The best way to quantitate venous reflux is still a matter of debate. Duplex-derived valve closure time (VCTs) have been used recently because they can be measured easily. We examined the relationships between VCT and duplex-obtained quantitation of venous volume and between VCT and air plethysmography (APG). Sixty-nine legs in 45 patients with varying clinical degrees of chronic venous insufficiency were studied by duplex scan and APG. VCTs were compared with duplex-derived flow calculations and with APG-derived venous filling index and residual volume fraction. The patient's mean age was 47.5 +/- 13.9 years; the mean duration of their symptoms was 13 +/- 4 years. Twenty percent had a history of deep venous thrombosis, and 29% had undergone venous surgery. No correlation was found between VCT and flow volume or between VCT and flow at peak reflux at any of the anatomic locations studied: saphenofemoral junction, greater saphenous vein, lesser saphenous vein, superficial femoral vein, profunda femoris vein, and popliteal vein. Likewise, no correlation was found between total VCT and APG-derived venous filling index or between total flow volumes and APG-derived residual volume fraction. Total VCT and total flow volumes did, however, have a moderate correlation (r = 0.65; p = 0.0003). Duplex-derived VCTs, although extremely useful in determining the presence of reflux, do not correlate with the magnitude of reflux, and should not be used to quantitate the degree of reflux.
定量评估静脉反流的最佳方法仍存在争议。最近开始使用双功超声衍生的瓣膜关闭时间（VCTs），因为它们易于测量。我们研究了VCT与双功超声获得的静脉容量定量之间的关系，以及VCT与空气容积描记法（APG）之间的关系。通过双功超声扫描和APG对45例具有不同临床程度慢性静脉功能不全的患者的69条腿进行了研究。将VCTs与双功超声衍生的血流计算结果以及APG衍生的静脉充盈指数和残余容积分数进行比较。患者的平均年龄为47.5±13.9岁；症状的平均持续时间为13±4年。20%的患者有深静脉血栓形成史，29%的患者接受过静脉手术。在所研究的任何解剖部位：隐股静脉交界处、大隐静脉、小隐静脉、股浅静脉、股深静脉和腘静脉，均未发现VCT与血流量或VCT与反流峰值时的血流之间存在相关性。同样，总VCT与APG衍生的静脉充盈指数之间，以及总血流量与APG衍生的残余容积分数之间均未发现相关性。然而，总VCT与总血流量之间存在中度相关性（r = 0.65；p = 0.0003）。双功超声衍生的VCTs虽然在确定反流的存在方面极为有用，但与反流的程度无关，不应被用于定量反流程度。
