Nöbet öncesi ve sonrası hemşirelerde alt ekstremite venöz Dupleks ultrasonografi bulguları

Amaç: Bu çalışmada hemşirelerde iki farklı reflü provokasyon tekniği kullanılarak uzun süre ayakta kalmanın Dupleks ultrasonografi sonuçlarını değiştirip değiştirmediği araştırıldı ve bu tekniklerin sonuçlarının birbiriyle uyumlu olup olmadığı değerlendirildi.Ça lış ma pla nı: Şubat 2014 - Temmuz 2014 tarihleri arasında, 12 saatlik nöbet öncesi ve sonrasında Dupleks ultrasonografi ile 32 hemşirenin (30 kadın, 2 erkek; ort. yaş 31.3±5.1 yıl; dağılım 23-46 yıl) 64 alt ekstremitesi ileriye dönük olarak değerlendirildi. Ultrasonografik incelemeler aynı radyolog tarafından benzer koşullarda gerçekleştirildi. Hemşirelerin çalışma süresi kaydedildi ve nöbet öncesi ve nöbetin hemen sonrasında incelendi. Manuel kompresyon ve Valsalva manevrası ile reflü provoke edildi. Pretibiyal ödem kaydedildi. Spektral veriler, derin ve yüzeyel ven segmentlerinden elde edildi.Bul gu lar: Nöbet öncesinde sadece bir hemşirede ödem vardı; ancak, nöbet sonrası ek olarak beş hemşirede iki taraflı ödem gelişti (p=0.002). Pretibiyal ödemli hemşirelerin çalışma süresi, anlamlı düzeyde daha uzundu. Tüm segmentlerde, iki teknik ile de nöbet öncesi ve sonrası ölçümlerde anlamlı bir fark yoktu (p>0.05). Manuel kompresyon ve Valsalva manevrası teknikleri derin venlerde "hiç" ya da "zayıf" uyumluluk gösterirken, yüzeyel venlerde bu "makul" veya "iyi" uyumluluk gösterdi.So nuç: Çalışma bulgularımız, nöbet sonrasında pretibiyal ödemde anlamlı artış ile her iki reflü provokasyon tekniğinin de nöbet öncesi ve sonrası benzer sonuçlar verdiğini göstermektedir.

Lower extremity venous Duplex ultrasonographic findings in nurses before and after nightshifts

Background: This study aims to investigate whether prolonged standing changed Duplex ultrasonography findings in nurses using two different reflux provocation techniques and to assess whether the findings of these techniques were in agreement.Methods: Between February 2014 and July 2014, 32 nurses (30 females, 2 males; mean age 31.3±5.1 years; range 23 to 46 years) with a total of 64 lower extremities were evaluated prospectively using the Duplex ultrasonography before and after 12 hour nightshifts. Ultrasonographic examinations were performed by a single radiologist under similar conditions. Duration of working of the nurses was noted and examined prior to nightshifts and immediately following the nightshifts. Reflux was provoked by manual compression and Valsalva maneuver. Pretibial edema noted. Spectral data were obtained from deep and superficial vein segments.Results: Prior to nightshifts, there was edema in only one nurse; however, bilateral edema developed in five additional nurses after nightshifts (p=0.002). Working duration of nurses with pretibial edema was significantly longer. In all vein segments, we found no significant differences in measurements before and after nightshifts using either technique (p>0.05). Manual compression and Valsalva maneuver showed either "no" or "poor" agreement in deep veins, while they showed either "fair" or "good" agreement in superficial veins.Conclusion: Our study results show that both reflux provocation techniques yield similar outcomes before and after nightshifts with significantly increased pretibial edema after nightshifts.

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