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Z Orthop Ihre Grenzgeb 2005; 143(1): 112-116
DOI: 10.1055/s-2004-820346
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© Georg Thieme Verlag Stuttgart · New York

Reliabilität der transkutanen Sauerstoffpartialdruckmessung an der unteren Extremität

Reliability of Transcutaneous Measurement of Oxygen Tension on the Lower LegW. Käfer1 , S. Kinkel1 , C. R. Fraitzl1 , C. B. Clessienne1 , W. Puhl1 , K. Huch1
  • 1Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm
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Publication History

Publication Date:
08 March 2005 (online)

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Zusammenfasssung

Studienziel: Die transkutane Messung des Sauerstoffpartialdrucks dient der Beurteilung der lokalen Durchblutungssituation. Zunehmend wird sie auch in der Orthopädie als Entscheidungshilfe zur Bestimmung der Amputationshöhe eingesetzt. Ziel der Studie war die Analyse der Reliabilität der Methode an einer homogenen Probandengruppe. Methode: Fünf Untersucher führten an sieben Probanden eine transkutane Sauerstoffpartialdruckmessung an beiden dorsalen Unterschenkeln, 20 cm unterhalb des medialen Gelenkspalts durch. Die Testreihe wurde einen Tag später analog wiederholt. Für die Messungen wurde das TCM™ 400 Transkutanes pO2 Monitoring System der Fa. Radiometer Medical A/S (Brønshøj, Dänemark) verwandt. Die statistische Analyse der intra- und interindividuellen Reliabilität erfolgte mittels Spearman Rangkorrelationskoeffizient. Ergebnisse: Der Mittelwert für die Messwerte beider Untersuchungszeitpunkte aller Probanden betrug 56,2 ± 10,6 mmHg. Zum Untersuchungszeitpunkt 1 fand sich ein Mittelwert von 55,3 ± 10,6 mmHg, zum Untersuchungszeitpunkt 2 ein Mittelwert von 57,0 ± 10,5 mmHg. Die Analyse der intraindividuellen Messwertunterschiede ergab einen Spearman Korrelationskoeffizient von rs = 0,56 (p < 0,0001), die paarweise Analyse der interindividuellen Reliabilität inhomogene Rangkorrelationskoeffizienten zwischen rs = 0,20 (p = 0,20) und rs = 0,69 (p = 0,0004). Schlussfolgerung: Bei der transkutanen Sauerstoffpartialdruckmessung sollte die objektivierte inhomogene intra- und interindividuelle Reliabilität bei der Befundauswertung und den therapeutischen Schlussfolgerungen mit in Betracht gezogen werden. Nur durch Mehrfachmessungen und in Zusammenschau mit weiteren Untersuchungsverfahren (z. B. Angiographie) kann eine zuverlässige Befundbeurteilung erfolgen und somit die für den individuellen Patienten adäquate Therapie geplant werden.

Abstract

Aim: Measurement of transcutaneous oxygen tension is increasingly used to determine the appropriate level of amputation in patients with vascular disease. The purpose of the present study was to analyze the intra- and interrater reliability of transcutaneous oxygen [tcpO2] measurements in a homogeneous study group. Method: Five investigators assessed the transcutaneous oxygen tension of both lower legs of seven persons in a fixed setting. Assessment was repeated with the same examiners and the same examinees after 24 hours. TcpO2 was measured at the posterior aspect of the lower leg twenty centimeters below the knee joint line. The TCM™ 400 Monitoring System (Radiometer Medical AIS, Brønshøj, Denmark) was used. Statistical analysis of the intra- and interrater reliability was performed with the Spearman coefficient of correlation. Results: An overall mean of 56.2 ± 10.6 mmHg was found. For the first examination, a mean of 55.3 ± 10.6 mmHg was observed, whereas for the second examination it was 57.0 ± 10.5 mmHg. Analysis of intrarater reliability showed a coefficient of correlation of rs = 0.56 (p < 0.0001). For interrater reliability, we found coefficients of correlation ranging from rs = 0.20 (p = 0.20) to rs = 0.69 (p = 0.0004). Conclusion: Analysis of transcutaneous oxygen tension measurements performed by different investigators in a fixed setting revealed a non- homogeneous intra- and interrater reliability, which should be taken into account prior to initiating therapy.





Schlüsselwörter

Amputation - Reliabilität - Sauerstoffpartialdruckmessung - transkutan

Key words

Amputation - oxygen measurement - reliability - transcutaneous

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PD Dr. med. Klaus Huch

Orthopädische Klinik mit Querschnittgelähmtenzentrum der Universität Ulm

c/o Rehabilitationskrankenhaus Ulm

Oberer Eselsberg 45

89081 Ulm

Phone: 07 31/1 77 51 07

Fax: Fax: 07 31/1 77 11 03

Email: klaus.huch@rku.de