二维及彩色多普勒联合灰阶血流快速筛查晚孕妇女下肢静脉疾病

目的评价二维及彩色多普勒（CDFI）联合灰阶血流（B-flow）快速筛查晚孕妇女下肢静脉疾病的价值。方法2007年9月至2008年1月对60例排除其他可能引起血管病变原因的晚孕期妇女，于产前及产后应用二维及CDFI联合B-flow测量双下肢静脉管径及流速，记录血管内情况、静脉瓣活动及反流情况，并进行产前、产后对比。结果晚孕妇女产前双下肢静脉较产后显著增宽[（11．5±1．5）mm与（8．44±1．0）mm，t=7．14，P〈0．01]，血流速度明显减慢[（11．54±4．0）cm／s与（29．74±6．9）cm／s，t=-15．74，P〈0．01]。57例（95％）孕妇静脉内出现自发显影现象，21例（35％）胴静脉及39例（65％）的大、小隐静脉CDFI显示困难，需要B-flow完成。产前隐股静脉瓣及股浅静脉瓣的反流发生率均为24％；20％的股浅静脉瓣及10％的隐股静脉瓣有瓣膜袋血栓形成，产后2周内可消失，未发生肺栓塞。结论二维及CDFI联合B-flow能快速筛查晚孕妇女下肢静脉疾病。

Application of two-dimensional and color Doppler ultrasonography and B-blood flow to quickly screen venous diseases of lower extremities in late pregnant women

Objective To evaluate the value of two-dimensional (2D) and color Doppler ultrasonography and B-blood flow (B-flow) in quick screening for venous diseases of the lower extremities in late pregnant women. Methods Sixty late pregnant women excluding other-cause blood vessel diseases were recruited during September 2007 to January 2008 and underwent 2D and color Doppler ultrasonography and B-blood flow examinations for diameter and blood flow velocity of the veins in their both lower extremities during prenatal and postnatal periods to record intravenous condition, activities of the venous valve and venous valvular regurgitation in detail. Results Diameters of the veins in beth lower extremities of the late pregnant women widened significantly during prenatal period, as compared to that in postnatal period [(11.5±1.5) mm vs. (8.4±1.0) mm, t =7.14, P <0.01] and their blood flow velocity slowed down significantly in prenatal period than that in postnatal period [(11.5±4.0) cm/s vs. (29.7±6.9) cm/s, t =-15.74, P <0.01]. Spontaneous enhancement phenomenon could be shown in their veins in 57 of 60 (95%) pregnant women by 2D and color Doppler ultrasonography, but could not be shown by 2D and color Doppler uhrasonography in the poplitel veins in 21 pregnant women (35%) or in the small and great saphenous veins in 39 pregnant women (65%), which should be activated by B-flow. Venous valvular regurgitation occurred in the great saphenous veins and the superficial femoral veins in 24 percent of pregnant women during prenatal period, and small venous valve bag thrombus formed in 20 percent of the superficial femoral veins and 10 percent of the great saphenous veins, but disappeared two weeks after delivery, without formation of pulmonary embolism. Conclusion Tow-dimentional and color Doppler ultrasonography and B-blood flow examinations can be used in late pregnant women to quickly screen for venous diseases in their lower extremities.