彩色多普勒超声在原发性下肢深静脉瓣功能不全中的应用

目的　应用彩色多普勒超声诊断原发性下肢深静脉瓣功能不全。方法　应用彩色多普勒超声检测了２２个病人（３６条腿）和１５个正常人（３０条腿）的下肢股浅静脉、腘静脉瓣及内径、彩色返流信号、血流频谱及时间平均流速（ＴＡＶ）。结果　２２个深静脉瓣功能不全的病人均有股浅静脉〔（９．３６±２．０） ｍ ｍ ｖｓ（５．３５±１．０） ｍ ｍ ； Ｐ＜ ０．００１〕和腘静脉〔（９．９０±２．３） ｍ ｍ ｖｓ （５．０６±１．４） ｍ ｍ ， Ｐ＜ ０．０１〕的扩张； ＴＡＶ股浅静脉〔（３．９０±２．３） ｃｍ ／ｓ ｖｓ （６．５０±２．２） ｃｍ ／ｓ〕和腘静脉〔（２．７５±２１） ｃｍ ／ｓｖｓ （５．７５±２．３） ｃｍ ／ｓ， Ｐ＜ ０．００１〕明显减慢。在Ｖａｌｓａｌｖａ＇ｓ或平静呼吸时显示有彩色返流信号， 脉冲多普勒显示呈双向频谱， 其中， 股浅静脉瓣３例， 腘静脉瓣１４例， 双瓣１９例。正常组腘静脉瓣１例。二组差别有极显著意义。结论　彩色多普勒超声能明确瓣膜的返流的部位及返流程度， 诊断下肢深静脉瓣功能不全。对外科合理地选择手术方式及部位， 并在术后观察疗效。

Color Doppler flow imaging in the application of the primary deep venous incompetence

Objective To Diagnose the primary deep venous incompetence by color Doppler flow imaging(CDFI).Methods Valvular competence of deep veins in 22 patients(36 limbs)and 15 normal cases (30limbs)were studied with CDFI.Results The results showed dilation in all of the lumens of the femoral veins(9.36±2.0)mm vs(5.35±1.0)mm,P<0.001] and popliteal veins(9.90±2.3)mm vs(5.06±1.4)mm,P<0.01],time average velocity(TAV)was obviously reduced in the femoral vein(3.90±2.3)cm/s vs(5.75±2.9)cm/s,P<0.001] and popliteal veins(2.75±2.1)cm/s vs(5.75±2.9)cm/s]with primary deep venous incompetence(PDVI).CDFI revealed reflux and Dopper spectrum showed that wave pattern from both up and down the baseline in the pulse Doppler during breathing and vasalva maneuver in 3 cases of alone the fenioral valve,14 cases of alone the popliteal,19 cases of both femoral and popliteal valve with PDVI,and one case of the popliteal in normal limbs.There were significant difference between the PDVI and normal group.Concl usions The primary deep venous incompetence of lower extremties could be detected,the positions of the reflux could be revealed and the degree of the reflux could be assessed in valve of the deep veins in the lower legs by CDFI.The position of valve in deep veins with PDVI can be correctly selected before an operation and clinical effect can be observed after an operation for surgery.