压迫对下肢静脉、动脉主血流速度及皮肤微循环的影响

V. I. Rusin, F. M. Pavuk, V. Y. Fedusyak
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摘要

目标。研究压迫对健康个体和失代偿型静脉曲张及血栓后静脉炎综合征患者下肢静脉和动脉主血流速度以及足后部皮肤微循环的影响。材料和方法。在调查中,56人被分为三组:第一组- 20名健康人;II组:失代偿期静脉曲张病患者15例;III组:21例失代偿期血栓后静脉炎综合征患者。在使用不同等级的医用弹性针织品或袖带压力前后,测量所有受试者的踝臂压力指数、股深腘窝指数、区域灌注指数、经皮氧分压和二氧化碳分压、股动脉动脉血流速度和隐股交界远端静脉血流量。结果。在III类压缩患者中,经皮记录的指标在氧气分压和二氧化碳分压之间发生交叉,并伴有二氧化碳分压超过氧气分压的优势,同时压缩等级进一步提高。在II组患者中,仅应用IV类压迫时观察到这种倾向。在调查开始时,III组患者的二氧化碳分压值高于II组患者(p=0.0001)。结论。当应用III类压缩时,与初始值相比,II组患者的髋关节静脉血流量平均降低了78%,III组患者的平均降低了7.4倍(p=0.0001)。对于失代偿的血栓后静脉综合征患者,应用I-II类弹性压迫是负担得起的,而对于失代偿期的静脉曲张患者,应用III类和iV类弹性压迫也是负担得起的。
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Impact of compression on velocity of venous and arterial main blood flow and cutaneous microcirculation of the lower extremity
Objective. To study the impact of compression on velocity of venous and arterial main blood flow of the lower extremity, as well as cutaneous microcirculation in the back part of the foot in healthy individuals and patients with decompensated forms of varicose disease and postthrombophlebitis syndrome. Materials and methods. In the investigation 56 individuals took part and divided into three groups: Group I – 20 healthy persons; Group II – 15 patients with varicose disease in decompensated stage; Group III– 21 patients with decompensated stage of postthrombophlebitis syndrome. In all participants of the investigation the index of ankle–brachial pressure, deep–femoro–popliteal index, the regional perfusion index, transcutaneous partial pressure of oxygen and partial pressure of carbon dioxide, the arterial blood flow velocity in femoral artery and of venous blood flow distally from sapheno–femoral junction were measured before and after application of elastic medical knitwear of various Class of compression or the cuff pressure. Results. In the Class III compression in patients of Group III the transcutaneously registered indices crossing have occurred between partial pressure of oxygen and carbon dioxide, accompanied by domination of the carbon dioxide partial pressure over the oxygen partial pressure while further enhancement of the compression Class. In patients of Group II this tendency was observed while application of Class IV compression only. At the investigation beginning the values of partial pressure of carbon dioxide registered were higher in the Group III patients, than in the patients of Group II (p=0.0001). Conclusion. While application of the Class III compression the velocity of the hip venous blood flow, comparing with its initial values, have lowered at average by 78% in patients of Group II and at average in 7.4 times in the patients of |Group III (p=0.0001). It is affordable in patients, suffering decompensated postthrombophlebitic syndrome, to apply the elastic compression of Classes I–II, while in those, having varicose disease in decompensated stage, – the elastic compression of Classes III and iV as well.
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