Alt ekstremite venöz yetmezliğinde Doppler US: Valsalva manevrası mı, pnömatik kompresyon mu?
Küçük Resim Yok
Tarih
2004
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ Doppler ultrasonografi ile alt ekstremite derin venöz ve safenofemoral yetmezliği belirlemede "Valsalva manevrası" ve "pnömatik kompresyon" yöntemlerinin karşılaştırılması. GEREÇ VE YÖNTEM Alt ekstremite venöz sistemine yönelik Doppler US incelemesi yapılan 43 hastada değerlendirilen 81 ekstremite çalışmaya dahil edildi. Venöz yetmezlik araştırması erekt postürde "Valsalva manevrası" ve "pnömatik kompresyon" yöntemleri ile yapıldı. Valsalva manevrası sırasında kranyal segmentinde yüzeyel femoral ven, popliteal ven kranyal segmenti, vena safena magnanın femoral ven bileşkesine yakın kranyal segmenti ve diz medialindeki kaudal segmentinde spektral Doppler US inceleme ile reflü araştırıldı. Aynı ölçümler diz altında bacağa sarılan tansiyon aleti manşonunun 200 mmHg basınca kadar şişirilmesi ile uygulanan kompresyonun ani gevşetilmesi sırasında tekrarlandı. Bin msn üzerinde devam eden ters akım yetmezlik için anlamlı kabul edildi. Tüm seviyeler için her iki yöntemin sonuçları McNemar testi ile karşılaştırıldı. BULGULAR İncelenen 81 ekstremitenin 61’inde derin venöz ve/veya safenofemoral yetmezlik saptandı. Vena safena magna kaudal segmenti ve popliteal vende manşon testinin, yüzeyel femoral vende ise Valsalva manevrasının daha başarılı olduğu görüldü. İkibin msn üzerindeki daha ciddi reflüler dikkate alınarak McNemar testi tekrarlandığında istatistik sonuçları değişmedi. SONUÇ Valsalva manevrası ve manşon testi yöntemlerinin birlikte kullanılması alt ekstremite venöz yetmezliklerinin saptanma ve doğru değerlendirme oranını arttıracaktır.
PURPOSE: To compare the efficacy of Valsalva maneuver and pneumatic compression techniques in detecting lower extremity deep venous and saphenofemoral insufficiency. MATERİALS AND METHODS: Eighty-one extremities evaluated in 43 patients who had undergone Doppler ultrasound examination of the lower extremity venous system were included in the study. Valsalva maneuver and pneumatic cuff techniques were used to elicit reflux in the standing position. Reflux was investigated with spectral Doppler in the superficial femoral vein, popliteal vein, the proximal segment of the great saphenous vein close to its junction with the femoral vein and in its caudal segment at the medial aspect of the knee. The same measurements were repeated after rapid deflation of the pneumatic cuff, which was applied to the calf and was initially inflated to 200 mmHg. Retrograde flow exceeding 1000 msec was regarded as insufficiency. The results of the two techniques at each venous segment were compared with the McNemar test. RESULTS: Deep venous and/or saphenofemoral insufficiency were detected in 61 of the 81 extremities. The cuff deflation technique was superior at the popliteal vein and caudal segment of the great saphenous vein. The Valsalva maneuver was superior at the superficial femoral vein. The statistical results did not change when the McNemar test was repeated for reflux exceeding 2000 msec. CONCLUSION: Combined application of Valsalva maneuver and pneumatic cuff techniques will lead to more accurate evaluation and increased detection of lower extremity venous insufficiency.
PURPOSE: To compare the efficacy of Valsalva maneuver and pneumatic compression techniques in detecting lower extremity deep venous and saphenofemoral insufficiency. MATERİALS AND METHODS: Eighty-one extremities evaluated in 43 patients who had undergone Doppler ultrasound examination of the lower extremity venous system were included in the study. Valsalva maneuver and pneumatic cuff techniques were used to elicit reflux in the standing position. Reflux was investigated with spectral Doppler in the superficial femoral vein, popliteal vein, the proximal segment of the great saphenous vein close to its junction with the femoral vein and in its caudal segment at the medial aspect of the knee. The same measurements were repeated after rapid deflation of the pneumatic cuff, which was applied to the calf and was initially inflated to 200 mmHg. Retrograde flow exceeding 1000 msec was regarded as insufficiency. The results of the two techniques at each venous segment were compared with the McNemar test. RESULTS: Deep venous and/or saphenofemoral insufficiency were detected in 61 of the 81 extremities. The cuff deflation technique was superior at the popliteal vein and caudal segment of the great saphenous vein. The Valsalva maneuver was superior at the superficial femoral vein. The statistical results did not change when the McNemar test was repeated for reflux exceeding 2000 msec. CONCLUSION: Combined application of Valsalva maneuver and pneumatic cuff techniques will lead to more accurate evaluation and increased detection of lower extremity venous insufficiency.
Açıklama
Anahtar Kelimeler
Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme
Kaynak
Tanısal ve Girişimsel Radyoloji (Yeni Adı: Dİagnostic & Intervent. Radiol)
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
2
