足部静脉压力测量用于评估下肢静脉功能不全。

Fukuoka M, Okada M, Sugimoto T

Department of Surgery, Kobe University School of Medicine, Japan.

J Vasc Surg. 1998 Apr;27(4):671-6. doi: 10.1016/s0741-5214(98)70232-0.

PURPOSE

Foot venous pressure measurement is considered to be useful for assessing lower limb venous insufficiency, because venous hypertension is the main factor predisposing to venous insufficiency. In this study, we investigated the utility of foot venous pressure measurement in the evaluation of venous insufficiency.

METHODS

A total of 148 limbs of 101 patients with venous insufficiency associated with varicose veins and treated over 5 years were studied. The measurements assessed were percentage decrease in foot venous pressure with manual calf compression (%drop), rate of increase in foot venous pressure during a 4-second period after release of compression (4SR%), and time to 50% recovery of foot venous pressure (RT50).

RESULTS

A higher incidence of skin changes (clinical, etiologic, anatomic, and pathophysiologic classification classes 4 to 6) caused by venous insufficiency was associated with %drop, 4SR%, and RT50 values. Skin changes were found in more than 50% of the limbs with a %drop less than 50%, 4SR% more than 50%, or RT50 less than 4 seconds. After tourniquets were applied to occlude the superficial veins, limbs with severe below-knee deep venous reflux (%drop 60.3 +/- 14.6, 4SR% 36.7 +/- 30.2, RT50 13.9 +/- 14.7) showed significantly worse values than those with no reflux (%drop 79.9 +/- 3.2, 4SR% 8.1 +/- 3.1, RT50 48.9 +/- 17.9) or with mild above-knee reflux (%drop 77.0 +/- 5.0, 4SR% 7.1 +/- 3.2, RT50 46.9 +/- 26.7). After sclerotherapy or surgical treatment, including deep venous reconstruction for severe below-knee reflux, all limbs showed significant improvement in clinical manifestations and foot venous pressure values (%drop 68.1 +/- 7.5 to 76.5 +/- 5.8, 4SR% 33.1 +/- 12.9 to 12.7 +/- 7.6, RT50 7.5 +/- 4.2 to 20.1 +/- 6.5).

CONCLUSION

Foot venous pressure measurements showed a good correlation with clinical severity and degree of venous reflux and were very useful for evaluating the outcome of therapy for venous insufficiency.

目的

足部静脉压测量被认为有助于评估下肢静脉功能不全，因为静脉高压是导致静脉功能不全的主要因素。在本研究中，我们调查了足部静脉压测量在评估静脉功能不全中的作用。

方法

对101例患有与静脉曲张相关的静脉功能不全且接受治疗超过5年的患者的148条肢体进行了研究。所评估的测量指标包括手动压迫小腿时足部静脉压的下降百分比（%下降）、压迫解除后4秒内足部静脉压的上升速率（4SR%）以及足部静脉压恢复到50%所需的时间（RT50）。

结果

由静脉功能不全引起的皮肤变化（临床、病因、解剖和病理生理分类4至6级）的发生率较高与%下降、4SR%和RT50值相关。在%下降小于50%、4SR%大于50%或RT50小于4秒的肢体中，超过50%出现了皮肤变化。在应用止血带阻断浅静脉后，伴有严重膝下深静脉反流的肢体（%下降60.3±14.6，4SR% 36.7±30.2，RT50 13.9±14.7）的各项指标明显比无反流的肢体（%下降79.9±3.2，4SR% 8.1±3.1，RT50 48.9±17.9）或伴有轻度膝上反流的肢体（%下降77.0±5.0，4SR% 7.1±3.2，RT50 46.9±26.7）更差。在进行硬化疗法或手术治疗后，包括对严重膝下反流进行深静脉重建，所有肢体的临床表现和足部静脉压值均有显著改善（%下降从68.1±7.5至76.5±5.8，4SR%从33.1±12.9至12.7±7.6，RT50从7.5±4.2至20.1±6.5）。