Clinical Assessment of Patients with Peripheral Arterial Disease
Clinical Assessment of Patients with Peripheral Arterial Disease
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DOI：
10.1055/s-0034-1393964
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发表时间：
2014-12-01
影响因子：
1.4
通讯作者：
Scott, D. Julian A.
中科院分区：
文献类型：
--
作者：
Bailey, Marc A.;Griffin, Kathryn J.;Scott, D. Julian A.
外周动脉疾病（PAD）描述了影响腿部循环的动脉粥样硬化的临床表现。 PAD 的严重程度根据症状严重程度、时间进程和解剖分布进行分类。 PAD 的体征和症状反映了循环受损的程度以及循环是否逐渐减少或突然、无代偿性减少。准确的临床评估是管理策略决策的基础，并应客观评估缺血的严重程度和血运重建的需要。临床病史应将 PAD 症状与其他表现为腿部疼痛的疾病区分开来，阐明心血管危险因素以及症状对患者生活质量的影响。临床检查包括一般心血管疾病和相关病症的体征，然后再评估肢体的循环和活力。必须通过使用手持多普勒确定踝臂压力指数来增强外周脉搏的触诊。需要对患者采取整体管理方法，并且必须包括改变心血管风险状态以及处理 PAD 的局部循环表现。
Peripheral arterial disease (PAD) describes the clinical manifestations of atherosclerosis affecting the circulation in the legs. The severity of PAD is classified according to symptomseverity, time course, and anatomical distribution. The signs and symptoms of PAD reflect the degree of circulatory compromise and whether there has been a gradual reduction in the circulation or an abrupt, uncompensated decrease. Accurate clinical assessment underpins decisions onmanagement strategy and should objectively assess the severity of the ischemia and need for revascularization. Clinical history should discriminate symptoms of PAD from other conditions presenting with leg pain, elucidate cardiovascular risk factors and the effect of symptoms on the patient's quality of life. Clinical examination includes signs of general cardiovascular disease and associated conditions before assessing the circulation and viability of the limb. Palpation of peripheral pulses must be augmented by determination of the ankle brachial pressure index using hand held Doppler. A whole patient approach to management is required and must include modification of cardiovascular risk status as well as dealing with the local circulatory manifestation of PAD.