仰卧位Valsalva试验和直立位袖带加压法诱导下肢静脉反流的超声对比研究

Evaluation of venous reflux of lower extremities by ultrasonography with different methods

目的 研究仰卧位Valsalva试验和直立位袖带加压法应用彩色多普勒超声评估下肢静脉反流的差异。方法 选择下肢慢性静脉功能不全患者60例（共69侧患肢）,选取股浅静脉第一对瓣膜、大隐静脉瓣膜和腘静脉瓣膜,分别在仰卧位Valsalva试验和直立位袖带加压法诱导下,进行彩色多普勒超声检查,检测和比较静脉瓣膜的反流情况。结果 直立位袖带加压法的反流时间比仰卧位Valsalva试验的反流时间平均少0.3～5.69 s。仰卧位Valsalva试验和直立位袖带加压法都能够诱导下肢静脉瓣膜反流,但后者的敏感性和特异性较前者增高。结论应用彩色多普勒超声评估下肢静脉瓣膜反流时,直立位袖带加压法诱导反流的特异性和敏感性均优于仰卧位Valsalva试验。

Objective To compare the cuff compression in erecting position with the Valsalva＇s maneuver in supine position in evaluation of venous reflux of lower-extremities by color Doppler ultrasonography. Methods Sixty patients （69 lower extremities ） confirmed as chronic venous insufficiency（CVI） by phlebography were enrolled. Patient underwent color Doppler ultrasonography examinations for venous reflux in lower extremities with Valsalva＇s maneuver in supine position and the cuff compression in erecting position, respectively. The venous reflux was assessed and compared at 3 venous sites： the first valve of superficial femoral vein, the valve of popliteal vein and the valve of saphenous-femoral vein. Results The reflux time with the cuff compression method was 0.3 -0.59 s, which was less than that with Valsalva＇s maneuver. Both the cuff compression and the Vallsalva＇s maneuver were able to elicit venous reflux, but the sensitivity and specificity of the former was higher than those of the latter. Conclusion The cuff compression in erecting position is superior toValsalva＇s maneuver in supine position to elicit venous reflux of lower-extremities by color Doppler ultrasonography.