{"id":116446,"date":"2014-10-10T00:00:00","date_gmt":"2014-10-10T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/calidad-de-vida-doppler-lineal-y-presion-transcutanea-de-oxigeno-en-pacientes-tratados-mediante-revascularizacion-percutanea-en-miembros-inferiores\/"},"modified":"2014-10-10T00:00:00","modified_gmt":"2014-10-10T00:00:00","slug":"calidad-de-vida-doppler-lineal-y-presion-transcutanea-de-oxigeno-en-pacientes-tratados-mediante-revascularizacion-percutanea-en-miembros-inferiores","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-clinicas\/calidad-de-vida-doppler-lineal-y-presion-transcutanea-de-oxigeno-en-pacientes-tratados-mediante-revascularizacion-percutanea-en-miembros-inferiores\/","title":{"rendered":"Calidad de vida, doppler lineal y presion transcut\u00e1nea de oxigeno en pacientes tratados mediante revascularizacion percutanea en miembros inferiores"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Fernando Luis Bernal Paez <\/strong><\/h2>\n<p>Resumen.  introducci\u00f3n: la valoraci\u00f3n de la eficacia de la revascularizaci\u00f3n conseguida tras la angioplastia transluminal percut\u00e1nea (atp) se realiza mediante el estudio con ultrasonidos (doppler). Sin embargo, el \u00e9xito de la atp evaluada a trav\u00e9s del doppler, no siempre conlleva el incremento de ox\u00edgeno en las porciones m\u00e1s distales de la extremidad tratada, ni la mejor\u00eda cl\u00ednica de los pacientes tratados.  objetivos: se pretende evaluar la eficacia de la revascularizaci\u00f3n conseguida con la atp en pacientes diab\u00e9ticos con isquemia cr\u00f3nica de miembro inferior mediante el cuestionario de calidad de vida sf-36, y determinar su correlaci\u00f3n con la determinaci\u00f3n de la presi\u00f3n transcut\u00e1nea de oxigeno (tcpo2), el \u00edndice tobillo-brazo (itb) y el grado de estenosis arterial.  materiales y m\u00e9todos: se ha realizado un estudio prospectivo que incluye a 350 pacientes consecutivos remitidos a la unidad de radiolog\u00eda vascular intervencionista del hospital universitario &quot;virgen de la arrixaca&quot; de murcia (desde el 01\/07\/2008 al 01\/01\/2014) para estudio por isquemia cr\u00f3nica cr\u00edtica de miembro inferior. Los pacientes se han evaluado mediante el cuestionario de calidad de vida sf-36, doppler lineal de las arterias tibial posterior y dorsal pedia, el itb, la tcpo2 y el grado de estenosis arterial mediante estudios radiol\u00f3gicos y, en su caso atp posteriormente. Un total de 172 pacientes se consideraron candidatos para la realizaci\u00f3n de atp, y suponen 179 extremidades inferiores tratadas que conforman este estudio, ya que en 7 pacientes el tratamiento bilateral.  resultados: el tratamiento mediante angioplastia transluminal muestra el incremento significativo de la calidad de vida de los pacientes tratados (p&lt;0,001) determinado mediante el cuestionario de calidad de vida sf-36; adem\u00e1s, mientras que la mejor\u00eda de la categor\u00eda funci\u00f3n f\u00edsica se ha correlacionado con el incremento de la tcpo2 (p&lt;0,001), la mejor\u00eda de la categor\u00eda funci\u00f3n social se ha correlacionado con el incremento del itb (p&lt;0,001). El an\u00e1lisis estad\u00edstico muestra una escasa correlaci\u00f3n entre las dos t\u00e9cnicas empleadas (tcpo2 e itb), mostrando que ambas t\u00e9cnicas valoran par\u00e1metros diferentes que s\u00f3lo se correlacionan en los casos en los que aumentan conjuntamente debido a la mejor\u00eda del paciente. Por ello, la posibilidad de determinaci\u00f3n de la tcpo2 en todos los pacientes, la ausencia de falsos positivos, negativos como sucede en la determinaci\u00f3n del itb y su correlaci\u00f3n estad\u00edstica con la mejor\u00eda de la funci\u00f3n f\u00edsica en la calidad de vida de los pacientes tratados refleja la importancia de la determinaci\u00f3n de la tcpo2 como el mejor par\u00e1metro en la valoraci\u00f3n de estos pacientes.  conclusi\u00f3n: este estudio confirma la mejor\u00eda cl\u00ednica obtenida tras la atp en la isquemia cr\u00f3nica de miembro inferior, se\u00f1alando que el aumento de la tcpo2 tiene un significado fisiol\u00f3gico de revascularizaci\u00f3n microvascular en el miembro tratado que puede considerarse como un factor pron\u00f3stico en la evoluci\u00f3n de los pacientes tratados.    abstract.  introduction: the efficacy of percutaneous transluminal angioplasty (pta) in achieving revascularization is assessed via ultrasound (doppler). However, the success of pta assessed via doppler does not always display an increase in oxygen in the more distal portions of extremities treated, nor clinical improvements in patients undergoing treatment.  aims: to assess the efficacy of pta in achieving revascularization in diabetic patients with chronic lower limb ischemia via the sf-36 quality of life questionnaire and determine its correlation with the measurement of transcutaneous oxygen pressure (tcpo2), the ankle-brachial pressure index (abpi) and the degree of arterial stenosis.  material &amp; method: a prospective study was performed involving 350 patients consecutively admitted to the vascular radiology intervention unit of the &quot;virgen de la arrixaca&quot; university hospital in murcia, southern spain (from 01\/07\/2008 to 01\/01\/2014) due to chronic critical lower limb ischemia. These patients were assessed using the sf-36 quality of life questionnaire, lineal doppler of the posterior tibial and dorsal pedis arteries, abpi, tcpo2 and the degree of arterial stenosis via radiological methods and, when appropriate, followed up by pta. A total of 172 patients were considered apt as candidates for pta, from which 179 lower limbs were treated and thus included in the study, since 7 patients were admitted for bilateral treatment.  results: treatment via pta provides a significant increase in quality of life in treated patients (p&lt;0.001) as determined via the sf-36 quality of life questionnaire; furthermore, while the improvements registered under the category physical functionality proves to be correlated with tcpo2 (p&lt;0.001), the improvements in social functionality are correlated with the increase in apbi (p&lt;0.001). The statistical analysis shows a low level of correlation between two of the techniques utilized (tcpo2 and apbi), proving that both methods assess different parameters which are only correlated in those cases in which values increase jointly due to overall improvements in patients. As a result, the chances of determining tcpo2 in all patients, the absence of false positives\/negatives, as commonly occurs with apbi, and the statistical correlation with improvements in physical functionality as part of the quality of life of treated patients reflects the importance of determining tcpo2 as the ultimate parameter in the assessment of such patients.  conclusion: the present study confirms the clinical improvements achieved following pta treatment of chronic lower limb ischemia, highlighting the fact that increases in tcpo2 provide a physiological indication of microvascular revascularization in treated limbs and may prove to be a determining factor in the prognosis of treated patients.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Calidad de vida, doppler lineal y presion transcut\u00e1nea de oxigeno en pacientes tratados mediante revascularizacion percutanea en miembros inferiores<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Calidad de vida, doppler lineal y presion transcut\u00e1nea de oxigeno en pacientes tratados mediante revascularizacion percutanea en miembros inferiores <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Fernando Luis Bernal Paez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 10\/10\/2014<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Miguel Alcaraz Ba\u00f1os<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: david Armero barranco <\/li>\n<li>Manuel De las heras gonzalez (vocal)<\/li>\n<li>Juan  Jos\u00e9 Hern\u00e1ndez morante (vocal)<\/li>\n<li>cristina Martinez conesa (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Fernando Luis Bernal Paez Resumen. introducci\u00f3n: la valoraci\u00f3n de la eficacia de la revascularizaci\u00f3n conseguida tras la [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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