藤原 美子¹, 加藤 由美¹, 山本 祐三¹, 菊田 健太¹, 福本 愛記¹, 宇山 二美¹, 富和 清訓², 仲川 喜之³, 谷口 晃⁴, 田中 康仁⁴

Yoshiko FUJIWARA¹, Yumi KATOU¹, Yuzou YAMAMOTO¹, Kenta KIKUTA¹, Aiki FUKUMOTO¹, Fumi UYAMA¹, Kiyonori TOMIWA², Yoshiyuki NAKAGAWA³, Akira TANIGUCHI⁴, Yasuhito TANAKA⁴

¹宇陀市立病院臨床検査科, ²南奈良総合医療センター整形外科, ³宇陀市立病院整形外科, ⁴奈良県立医科大学整形外科

¹Department of Clinical Laboratory, Uda City Hospital, ²Department of Orthopaedic Surgery, South Nara Prefecture General Medical Center, ³Department of Orthopaedic Surgery, Uda City Hospital, ⁴Department of Orthopaedic Surgery, Nara Medical University

キーワード : deep vein thrombosis, femoral vein flow velocity, isometric exercise, immobilization, brace

目的：装具による足関節固定下に各種下腿運動に伴う大腿静脈血流の変化について超音波診断装置を用いて計測し，下腿運動と深部静脈血流の相関について検討した．対象と方法：健常人87名，平均年齢41±11.2歳を対象に，安静時，2回/分，6回/分，12回/分の前脛骨筋，下腿三頭筋等尺性収縮運動時の大腿静脈の最高血流速度（cm/秒）・単位時間血流量（l/分）と運動直後最高血流速度（cm/秒）と安静時の血流速度に戻るまでの効果持続時間（秒）を計測した．統計学的解析は，Friedman testを用いHolm testで補正し有意差p<0.001とした．結果：最高血流速度平均値/単位時間血流量は，安静時，2回，6回，12回の順に22.5，44.4，46.1，46.8 / 0.50，0.86，0.87，0.88で，運動直後最高血流速度と効果持続時間は，2回，6回，12回の順に27.4，29.1，31.6 / 8，9，11であった．結語：最高血流速度平均値/単位時間血流量は，安静時に比し各運動回数で有意に増加したが，運動回数間では有意差を認めなかった．運動直後最高血流速度は6回，12回が2回に比し有意に増加し，効果持続時間は12回が他の運動回数より有意に延長していた．今回の調査結果は1分間の運動による静脈血流の変化を見たものであり，今後は実臨床において患者に各運動を行っていただき，DVT予防効果につき至適運動時間，運動間隔等，さらなる調査検討を行っていく予定である．

Purpose: The purpose of this study was to investigate flow changes of the deep femoral vein at different exercise patterns in a lower leg immobilized using an ankle brace. Subjects and Methods: Subjects were 87 healthy individuals (average age 41 years) without any history of diabetes, cardiovascular disease, or varix. Isometric exercise was performed using three patterns: 2 times/min, 6 times/min, and 12 times/min. For each exercise, the femoral vein flow velocity (peak velocity) and vein flow volume, and the peak velocity just after exercise and the time for peak velocity to return to resting velocity (the duration of exercise effect), were measured with ultrasonic diagnostic imaging equipment. Friedman test with post hoc Holm test was used for statistical analysis (p<0.001). Results: Peak velocity mean and volume for all three exercise patterns increased significantly compared with rest (p<0.001); however, no significant difference was found among these exercise patterns. The effect of 12 times/min exercise continued significantly longer than the other exercise patterns (p<0.001). Conclusion: The 12 times/min isometric exercise showed the highest peak velocity and flow volume and the longest duration of exercise effect. In the future, exercise periods and intervals per day should be studied to identify the optimal exercise for prevention of deep venous thrombosis.