彩超对曲张静脉管径和交通静脉反流与临床分级的相关性研究

目的应用彩色多普勒超声（彩超）对静脉曲张的患肢及正常肢体进行检查，探讨小腿交通静脉反流对临床分级的影响，并对比观察观察组及正常组下肢静脉的管径。方法站立位时通过彩色多普勒超声对观察组25例患者的39条患肢与正常组10例患者（健康下肢）和正常人的12条健康下肢进行检查，对比观察有无小腿交通静脉反流、静脉管径等参数；对小腿交通静脉反流与临床分级作相关分析。结果正常组小腿交通静脉管径均小于3mm．未见交通静脉反流。观察组小腿交通静脉管径大于4mm伴有反流者18条下肢，小腿交通静脉反流与临床分级具有相关性（Fisher＇s exact=0．005），有小腿交通静脉反流者临床分级更高。站立位观察组患者的下肢大隐静脉、股总静脉、股浅静脉、胭静脉管径较正常组健康者的增宽。结论有小腿交通静脉反流者临床分级更高，故应常规检查小腿交通静脉；下肢静脉曲张组静脉管径较正常者的增宽，因此，发现静脉管径明显增粗时，应观察静脉有无反流。

CDFI study on correlation of perforating vein incompetence with clinical classification and the diameter of lower extremity varicose veins

Objective To explore influence of perforating vein incompetence to clinical classification in lower extremity veins varicose patients,and observe the diameter of the veins by color Doppler flow imaging(CDFI).Methods Thirty-nine impaired lower limbs in 25 patients and 12 healthy limbs in 10 subjects were studied in standing position.The clinical severity of venous various was classified according to the clinical,etiolosic,anatomic,and pathophysiologic(CEAP)score.Perforator reflux in calf was measured and compared to clinical classification.The diameter of great saphenous vein(GSV),common femoral vein(CFV),superficial femoral vein(SFV)and popliteal vein(POPV)in two groups was measured.Results Perforator reflux time in calf was less than 0.5 s in healthy group,and the diameter of perforators in calf was less than 4 mm.The perforator reflux correlate with clinical classification(Fisher's exact = 0.005)significantly.The diameter of lower extremity varicose vein in patients group was significantly wider than that in healthy group.Conclusion The perforating vein in lower extremity vein was varicose patients should be evaluated by CDFI routinely,if the significant wider diameter of GSV were found whether there is reflux of GSV valve should be detected.