骨折术后下肢深静脉超声检查及诊断作用分析

目的:探讨骨折术后下肢深静脉超声检查的诊断作用.方法:选取我院2018年1月-2019年4月期间在本院行骨折内固定手术治疗且术后疑似下肢深静脉血栓的患者50例作为研究对象.患者先行彩色多普勒检查,随后行下肢深静脉造影.患者确诊后立即实施溶栓治疗,统计患者彩色多普勒超声诊断结果,下肢深静脉造影后,对比两者诊断情况.同时,观察下肢深静脉血栓形成患者溶栓前后血流频谱Vs、Vd和RI指标变化.结果:经彩超检查显示38例为术后下肢深静脉血栓形成,检出率为76. 00% (38/50),根据血栓形成情况分为周围型18例(36. 00% ),中央型22例(44. 00% ),混合型10例(20. 00% ),其中混合型下肢深静脉血栓形成占比最低,显著低于周围型和中央型,差异具有统计学意义(P<0. 05).下肢深静脉造影对术后下肢深静脉血栓形成检出率84. 00% ,略高于超声诊断76. 00% ,但是无显著差异(P>0. 05).与下肢深静脉造影相比,超声诊断符合率为90. 48% (38/42),无误诊者,漏诊者为9. 52% (4/42). 42例下肢深静脉血栓形成患者溶栓治疗前血流频谱显示:Vs(48. 06 ± 5. 03)cm/s、Vd(10. 36 ± 2. 39)cm/s、RI(1. 75 ± 0. 37);溶栓后为Vs(37. 06 ± 4. 11)cm/s、Vd(7. 69 ± 2. 67)cm/s、RI(2. 67 ± 0. 53);溶栓前后比较,差异均具有统计学意义(P<0. 05).结论:骨折术后下肢深静脉超声检查对于下肢深静脉血栓形成诊断准确性较高,可为临床溶栓治疗提供参考资料,可作为疑似患者的首选检查方法.

The Diagnostic Effect of Deep Vein Ultrasound Examination of Lower Limbs after Fracture Surgery

Objective:To investigate the diagnostic effect of deep vein ultrasound examination of lower limbs after fracture surgery.Methods:50 patients with suspected deep venous thrombosis of lower limbs who were treated with internal fixation for fracture in our hospital from January 2018 to April 2019 were selected as the research objects.Color doppler examination was performed first,followed by lower extremity deep venography.Thrombolytic therapy was performed immediately after diagnosis.The diagnostic results of color doppler ultrasonography and lower limb deep venography were compared.Meanwhile,the changes of blood flow spectrum Vs,Vd and RI before and after thrombolysis in patients with deep venous thrombosis of lower limbs were observed.Results:After colour to exceed examination display 38 cases of postoperative deep vein thrombosis of lower limb,detection rate was 76.00%(38/50),according to the situation of thrombosis is divided into around 18 cases(36.00%),the central type 22 cases(44.00%),10 cases of mixed type(20.00%),including hybrid lower extremity deep vein thrombosis accounts for more than the minimum,significantly lower than the surrounding and the central,statistically significant difference(p<0.05).The detection rate(84.00%)of postoperative deep venous thrombosis in lower limbs by deep venography was slightly higher than that by ultrasound(76.00%),but there was no significant difference(p>0.05).Compared with deep venography of lower limbs,the diagnostic coincidence rate of ultrasound was 90.48%(38/42),with no misdiagnosis and no missed diagnosis 9.52%(4/42).Before thrombolytic therapy,the blood flow spectra of 42 patients with deep venous thrombosis of lower limbs showed:Vs(48.065.03)cm/s,Vd(10.362.39)cm/s,RI(1.750.37).After thrombolysis,Vs(37.064.11)cm/s,Vd(7.692.67)cm/s,RI(2.670.53)were obtained.The differences were statistically significant before and after thrombolysis(p<0.05).Conclusion:ultrasound examination of deep vein in lower limbs after fracture surgery is of high diagnostic accuracy for deep vein thrombosis in lower limbs,which can provide references for clinical thrombolytic therapy and can be the preferred examination method for suspected patients.