تقويم اختبارات دوالي الطرف السفلي السريرية
Abstract
أجريت اختبارات الدوالي السريرية (شوارتز – برودي تراندلينبرغ – دلبي بيرتس) لجميع المرضى المقبولين في قسم الجراحة بتشخيص دوالي في الطرف السفلي في مشفى الأسد الجامعي باللاذقية بين عامي 2004-2007. شملت عينة البحث 85 مريضاً (107 طرف), لاحظنا أن اختبار شوارتز لا يقدم أية فائدة عند 56.5% من المرضى المصابين بالقصور الصمامي في الوريد الصافن الكبير, ولا يثبت سوى 25% من حالات القصور الصمامي في الصافن الصغير. شخص اختبار تراندلينبرغ 71%من حالات القصور الصمامي في الصافن الكبير و من 53.1% حالات القصور الصمامي في الوريد الصافن الصغير. اختبار بيرتس شخص 64.7% من حالات القصور الصمامي في الدوران الوريدي العميق في الطرفين السفليين. اختبارات الدوالي السريرية (شوارتز – برودي تراندلينبرغ – دلبي بيرتس) تتمتع بمصداقية عالية عند إيجابيتها، و لكن سلبيتها لا تنفي الإصابة لذلك نوصي بإجراء الفحص بالأمواج فوق الصوتية الملونة لجميع المرضى المصابين بدوالي الطرف السفلي.
Clinical varicose veins tests were done (Trandelenburg-Brodie test-Perthes' test Schwartz test) on all patients who were admitted in Surgery Department in Al-Assad university Hospital, Lattakia, with diagnosis of varicose veins in the lower extremities between 2004 and 2007.
The study included 85 patients (107 legs). We noticed that Schwartz test did not give us any benefits in 56,5% of patients who had valvular reflux in greater saphenous and proved only 25% of valvular reflux in lesser saphenous. The Trandelenburg-Brodie test diagnosed 71% of valvular reflux in greater saphenous and 53,1% of valvular reflux in lesser saphenous. Perthes' test diagnosed 64,7% of valvular reflux in deep venous systems in the lower extremities. Clinical varicose veins tests which have been done had high credibility when they were positive, while when they were negative did not exclude illness. So we recommend that all patients who have varicose veins should be sent for duplex ultrasonography.
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