超声弹性成像参数及CT值与妇科术后下肢深静脉血栓形成临床分期的相关性及疗效预测价值

目的:探究超声弹性成像参数及CT值与妇科术后下肢深静脉血栓形成(deep-vein thrombosis,DVT)临床分期的相关性及疗效预测价值。方法:选取2018年1月至2019年12月某院妇科术后下肢DVT患者(73例)作为研究对象进行回顾性分析,所有患者均经超声造影检查确诊,均行超声弹性成像检查、CT检查及凝血功能检测。比较不同疾病分期(急性期、亚急性期和慢性期)患者的超声弹性成像参数(超声弹性评分、应变值)、CT值和凝血功能指标[纤维蛋白原(Fib)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)],分析超声弹性成像参数及CT值与下肢DVT、疾病分期、凝血功能指标的相关性,比较不同疗效患者超声弹性成像参数及CT值,探讨其对疗效的预测价值。采用SPSS 22.0进行统计学分析。结果:急性期患者的超声弹性评分及应变值<亚急性期患者<慢性期患者,CT值及Fib、APTT、PT>亚急性期患者>慢性期患者,差异有统计学意义(P<0.05);超声弹性评分及应变值、CT值与下肢DVT的相关性显著(P<0.05);下肢DVT患者疾病分期及APTT、PT、Fib与超声弹性评分、应变值间存在负相关关系,与CT值间存在正相关关系(P<0.05);疗效良好者的超声弹性评分及应变值高于疗效不佳者,CT值低于疗效不佳者(P<0.05);超声弹性评分、应变值及CT值联合预测下肢DVT患者疗效的AUC为0.913,大于各指标单独预测,联合预测的敏感度为90.00%、特异度为85.71%。结论:超声弹性成像参数及CT值与妇科术后下肢DVT临床分期、凝血功能均具有相关性,且在预测下肢DVT患者疗效方面具有较高的应用价值,可为临床评估患者病情、制订措施提供指导。

Correlation between ultrasound elastography parameters and CT values and clinical stages of lower extremity deep-vein thrombosis after gynecological operation and their predictive values for curative effect

Objective To explore the correlation between ultrasound elastography parameters and CT values and the clinical stages of lower extremity deep-vein thrombosis(DVT)after gynecological surgery and their predictive values for curative effect.Methods From January 2018 to December 2019,73 patients confirmed by ultrosonography with lower extremity DVT after gynecological surgery in some hospital were selected for retrospective analysis.All the patients underwent ultrasound elastography,CT and coagulation function examinations.Ultrasound elastography parameters(ultrasound elasticity scores and strain values),CT values and coagulation indices(fibrinogen(Fib),activated partial thromboplastin time(APTT)and prothrombin time(PT))were compared in the patients at different disease stages(acute,subacute and chronic)so as to analyze the correlations of ultrasound elastography parameters and CT values with DVT,disease stages and coagulation function indexes.The ultrasound elastography parameters and CT values in the patients with different curative effect were explored to determine their predictive values for the curative effect.SPSS 22.0 was used for statistical analysis.Results The patients at subacute stage had the ultrasound elasticity scores and strain values significantly higher than those of the ones at acute stage while statistically lower than those of the ones at chronic stage,and the CT values and Fib,APTT and PT obviously lower than the ones at acute stage while significantly higher than those of the ones at chronic stage(P<0.05);there were significant correlations between ultrasound elasticity scores and strain values,CT values and lower extremity DVT(P<0.05);there were negative correlations between disease stages and APTT,PT,Fib and elasticity scores and strain values,and a positive correlation with CT values(P<0.05);ultrasound elasticity scores and strain values were higher in those with good curative effect than those with poor curative effect,and CT values were lower than those with poor curative effect(P<0.05).The AUC for the combination of ultrasound elasticity scores, strain values and CT values in predicting the curative effect of lower extremity DVT was 0.913, which was higher than that of each index alone, with a sensitivity of 90.00% and specificity of 85.71%. Conclusion Ultrasound elastography parameters and CT values both correlate with lower extremity DVT stages and coagulation function in the lower extremity DVT patients after gynaecological surgery, and have high values in predicting the curative effect of the patients, which can provide guidance for clinical assessment of patients' conditions and formulation of measures.