糖尿病下肢血管检查.PPTVIP

足部伤口的预后　Foot Lesion Healing Prognosis 愈合百分比%　Percentage probability / 足趾収縮圧　Toe Systolic Pressure 足趾圧　Toe Pressure 糖尿病患者　　 非糖尿病患者 (mmHg) 　　 Diabetic Non Diabetic Patient 20-30 30-55 55 40% 85% 97% 73% 100% 100% (Carter, 1993) PPG下肢静脉功能检查 Using PPG for venous assessment 应用红外光传感器检查微循环的静脉血流　　　　　　　　　　　　　　　　　　　　　　Uses infrared light sensor to measure venous blood volume in the microcirculation 检查整体的静脉循环情况　Assesses overall venous circulation 不针对单个静脉血管　Not vessel specific 通过止血袖带可以区分表浅静脉和深静脉的功能不全　　　　　　　　　　　　　　Can diagnose difference between superficial and deep venous incompetence using tourniquets 可用于筛查深静脉血栓形成　Can screen for the absence of DVT 应用PPG检查静脉　Venous Assessment Using PPG 脱去鞋袜　Remove stockings and footwear 将足放在绝缘板上　Place foot on insulated mat 调节高度使足部承担压力最小　Adjust height to minimise weight on feet 肥胖患者应适当依靠以减少静脉压迫　Obese patients should be reclined to reduce venous compression 传感器置于内踝上方10cm处（蓝线指示）　Fit sensor 10cm above the medial malleolus (blue cable) 使用ES-100V3检查时患者姿态 Patient Position using Rheo Dopplex 正常静脉PPG曲线　Normal PPG Curve 正常波形　Normal Waveform 正常患者的静脉PPG曲线应有正常的静脉再充盈时间（RT） 应用PPG检查静脉　Venous Assessment Using PPG 如果在5次足部背曲运动后, 静脉回复时间20秒则提示下肢静脉瓣膜正常. If Refill Time (RT) is greater than 20 seconds, then venous insufficiency is not present or is not significant. RT20s 静脈再充満期（休憩中） 静脉排空时相（运动时） 异常静脉PPG波形　Abnormal PPG Curve 异常波形　Abnormal Waveform DVT患者的VPPG曲线可以得到ACV/CFDI证实 应用PPG检查静脉　Venous Assessment Using PPG 如果在5次足部背曲运动后, 静脉回复时间20秒则提示下肢静脉瓣膜功能不全, 可使用止血带法鉴别病变部位. If Refill Time (RT) is less than 20 seconds then venous reflux is present. Apply the tourniquet cuff at the appropriate positions to determine the level of venous insufficiency, RT20S 应用PPG检查静脉　Venous Assessment Using PPG 静脉血从动脉端再充盈 Venous refill from arterial inflow 存在静脉功能不全 Venous incompetence present 预示存在深静脉血栓 Deep venous obstruction/ insufficiency 应用PPG检查静脉　Venous Assessment Using PPG 使用止血袖带检查PPG　VPPG assessment using tourniquets 第一部：使用用UTTq(大腿)止血带, 加压50-60mmHg。阻