下肢静脉功能不全小腿交通静脉的声像图特征

目的探讨下肢静脉功能不全小腿交通静脉的声像图特征。方法检查经手术确诊的下肢交通静脉不全的患者45例共225条小腿Cockett交通静脉,观测交通静脉的数目、部位、内径及血流速度,并与30例正常成年人80条交通静脉的观测结果比较。结果患病组与正常组小腿Cockett交通静脉的平均数目分别为4.1条和2.1条,内径为(3.9±0.6)mm和(1.8±0.6)mm,血流速度为(3.5±1.5)cm/s和(2.4±0.9)cm/s。上述测值两组间差异均有统计学意义(P<0.01)。患病组中第Ⅲ组Cockett交通静脉占10%,而正常组为0。结论下肢静脉功能不全小腿交通静脉的声像图特征为:静脉数目增多,血管内径增宽,血流速度升高,并可检测到第Ⅲ组Cockett交通静脉。     

二维彩色多普勒血流显像检测下肢静脉瓣功能

目的应用二维彩色多普勒血流显像检测下肢静脉瓣功能。方法检查55例患者的下肢静脉,二维超声检查静脉管腔及管壁有无异常,静脉瓣显示情况,测量各段静脉的内径。彩色多普勒观察静脉管腔内血流情况,脉冲多普勒检测血流速度与方向。结果55例病例中,双下肢病变38例,单侧下肢病变17例,其中左下肢病变9例,右下肢病变8例。大隐静脉瓣功能不全下肢25条,股静脉瓣功能不全下肢52条,腘静脉瓣功能不全下肢27条。病变下肢的静脉瓣膜闭合不良,病变静脉扩张,彩色多普勒血流显像可见瓣膜处明显的反流血流信号,挤压肢体远端放松后或作乏氏动作实验时,反流更加明显。结论二维彩色多普勒血流显像诊断下肢静脉瓣功能的敏感性和特异性高,并能判断反流程度。     

探讨下肢静脉瓣功能不全的二维彩色多普勒超声的声像图改变

目的：探讨下肢静脉瓣功能不全的二维彩色多普勒超声声像图改变。方法：应用二维彩色多普勒超声检查下肢静脉瓣功能不全９３例、１４２条腿,观察下肢静脉血管及瓣膜的解剖结构和血流动力学的改变。结果：有静脉瓣功能不全的患肢平均血流速度较健侧低Ｐ〈０．０５,患肢血管内径仅见大隐静脉较健侧明显增宽Ｐ〈０．０５,患肢深静脉内径与侧对比夫明显差别。结论：二维彩色多普勒超声能清楚显示下肢静脉血管的结构、血流状态、瓣膜有     

术前彩色多普勒定位功能不全的交通支静脉在下肢静脉性溃疡中的应用

目的 评价彩色多普勒超声用于下肢静脉性溃疡术前定位功能不全的交通支静脉的临床价值.方法 下肢静脉性溃疡患者60例,64条患肢.术前30例行彩色多普勒超声检查,30例行静脉顺行造影检查,比较两种检查方法对功能不全交通支静脉的检出数及检出率.结果 彩色多普勒超声和静脉顺行造影对于功能不全的交通支静脉的检出率比较差异无统计学意义（94.1% vs 96.7%,P＞0.05）.结论 彩色多普勒超声具有费用低,操作简便,可多角度、多方位及反复多次进行无创检查等特点,可精确定位功能不全的交通支静脉,可作为检查下肢静脉性首选的检查方法.     

后胡桃夹综合征患者彩色多普勒超声表现

目的 分析后胡桃夹综合征患者彩色多普勒超声表现,探讨彩色多普勒超声检查对后胡桃夹综合征的诊断价值.方法 回顾性分析8例经临床和相关检查确诊的后胡桃夹综合征患者的超声声像图.应用彩色多普勒超声检查观察左肾静脉的形态、走行,测量腹主动脉后方狭窄处和腹主动脉左侧扩张处左肾静脉的前后径、血流速度,计算狭窄处与扩张处的内径和血流速度比值.结果 彩色多普勒超声可清晰显示左肾静脉自肾门处注入下腔静脉的全程.本组8例胡桃夹综合征患者经多角度、多切面扫查均见左肾静脉穿越腹主动脉后方与腰椎之间隙汇入下腔静脉,狭窄处左肾静脉内径为(1.5±0.4)mm,血流速度为(154.5±30.1)cm/s;扩张处左肾静脉内径为(8.7±1.4)mm,血流速度为(22.8±3.4)cm/s;左肾静脉内径、血流速度比值分别为1:(6.5±0.5)及1:(7.2±0.9).结论 彩色多普勒超声检查可准确评价左肾静脉走行变异导致的左肾静脉扩张及血流动力学变化,对临床诊断、治疗后胡桃夹综合征具有重要的应用价值.     

应用彩色多普勒超声诊断小腿肌间静脉扩张及血栓形成

目的探讨彩色多普勒超声应用于小腿肌间静脉检查,在发现腓肠肌及比目鱼肌肌间静脉扩张及血栓形成中的价值。方法对腓肠肌及比目鱼肌肌间静脉均扩张的82名患者128支下肢静脉进行彩色多普勒超声检查,观测最宽内径及有无血栓形成或形成倾向。结果发现肌间静脉血栓8例(9.8%),其中4例(4.9%)并发肺栓塞;发生肌间静脉血栓的静脉内径(0.65±0.30)cm;其中并发肺栓塞的肌间静脉内径(0.62±0.29)cm;扩张的肌间静脉内具有血栓形成倾向管腔内见"泥沙流"9例(11.0%)。结论彩色多普勒超声可早期发现小腿肌间静脉扩张及血栓形成或血栓形成倾向,以辅助诊断肺栓塞的发生。     

彩色多普勒超声在微波腔内交通静脉闭合术中的监测作用

目的 评价彩色多普勒超声诊断下肢慢性静脉功能不全伴交通静脉功能不全的诊断准确率,探讨在实施微波腔内交通静脉闭合术中彩色多普勒超声的监测作用.方法 针对112例(122条下肢)下肢慢性静脉功能不全伴交通静脉功能不全患者,术前采取彩色多普勒超声检测与下肢静脉造影,经手术证实诊断后,比较2种检测方法 的诊断准确率;术中,在彩色多普勒超声引导下实施微波腔内交通静脉闭合术;观察术后患者病变静脉闭合情况.结果 术前彩色多普勒超声检出的功能不全交通静脉,均经手术证实,诊断准确率100%.静脉造影检出的功能不全交通静脉诊断准确率为81.15%;术前彩色多普勒检测、静脉造影具体检出病变交通静脉数与微创手术证实数一致.术后,全组病变大隐静脉、浅表曲张静脉、交通静脉凝固闭合完全,无深静脉血栓形成.结论 彩色多普勒超声检测能够准确地诊断下肢慢性静脉功能不全伴交通静脉瓣膜功能不全;借助彩色多普勒超声引导,实施微波腔内交通静脉闭合术,定位准确,手术安全、简捷、效果好.     

彩色多普勒超声在下肢交通静脉功能不全诊断中的作用和意义

目的探讨彩色多普勒超声在下肢交通静脉功能不全诊断中的作用和临床意义。方法回顾性分析45例(50条)因下肢静脉性溃疡而行内镜筋膜下交通静脉结扎(SEPS)术的临床资料。术前利用彩色多普勒超声(CDI)检出扩张或功能不全的交通静脉,将其定位与手术结果相比较,以检验彩色多普勒超声诊断的准确性。结果45例(50条)下肢,CDI共检出交通静脉224条。其中一侧下肢检出最少为3条,最多为6条。SEPS术共结扎交通静脉203条,一侧下肢结扎最少为2条,最多为6条,其中183条与CDI术前定位一致,CDI对功能不全交通静脉的诊断符合率为90.1%。结论彩色多普勒超声能准确地对扩张或功能不全的交通静脉诊断和定位,有助于术中寻找需结扎的交通静脉。     

CDFI评价下肢深静脉瓣功能不全程度的方法再探讨

目的：探讨彩色多普勒超声在评价下肢深静脉瓣功能不全程度中的应用价值.方法：选取下肢深静脉瓣功能不全患者63例（患肢81条）,正常对照组24例（肢体48条）,进行下肢静脉彩色多普勒超声检查,观察第一对股浅静脉瓣的反流面积（RA）、反流时间（RT）、反流速度（RV）,根据静脉逆行性造影结果对下肢深静脉瓣功能不全进行分级.结果：与对照组比较,病例组股浅静脉瓣RA增大、RT延长,两组间差异有统计学意义（P＜0.05）;超声测量的股浅静脉瓣RA与下肢深静脉瓣功能不全程度呈高度相关性（r=0.998）,而RT、RV与反流程度相关性差（r=0.574、0.170）.结论：利用彩色多普勒超声所测量股浅静脉第一对瓣膜RA在评价下肢深静脉瓣功能不全程度中有意义,根据RA大小可以初步判断下肢深静脉瓣功能不全的程度.     

彩色多普勒超声在颅脑损伤后围术期患者隐性孤立性小腿肌间静脉丛血栓中的应用

目的探讨彩色多普勒超声在颅脑损伤后围术期患者隐性孤立性小腿肌间静脉血栓中的应用价值.方法对解放军第一一三医院高压氧科收治的782例颅脑损伤后围术期患者行常规下肢深静脉彩色多普勒超声检查,分析孤立性小腿肌间静脉丛血栓的临床及声像图特点.结果小腿肌间静脉丛血栓119例,其中孤立性小腿肌间静脉丛血栓102例,合并近端深静脉血栓者17例.孤立性小腿肌间静脉丛血栓患者中,双肢病变13例(12.7%,13/102);单肢病变89例(87.3%,89/102),其中左侧52例(58.4%,52/89),右侧37例(41.6%,37/89).超声声像图示:受累静脉内径不规则增宽,管壁增厚,内膜粗糙,其内可见不均质异常实性回声,呈长条形,横切呈类圆形,阻塞部位管腔不能或部分能压闭;彩色多普勒超声示:无彩色血流显示或血流充盈缺损向心绕行.比目鱼肌血栓长度(2.1±0.8)cm,受累静脉内径(7.9±3.2)mm;腓肠肌血栓长度(1.7±0.6)cm,受累静脉内径(6.4±2.1)mm.比目鱼肌血栓长度及受累静脉内径大于腓肠肌,差异均有统计学意义(t值分别为4.87、4.96,P均<0.05).结论彩色多普勒超声是诊断颅脑损伤后围术期患者孤立性小腿肌间静脉丛血栓的首选方法,可显示血栓的部位、大小、累及范围,并可对血栓进行动态监测,为临床治疗及疗效评价提供可靠依据.     

Quantitative Doppler evaluation of the splenoportal venous system in various stages of cirrhosis: differences between right and left portal veins

PURPOSE: The purpose of our study was to evaluate the relationship between the splenoportal hemodynamics in patients with cirrhosis and the stage of the disease. METHODS: Patients with cirrhosis were grouped according to modified Child-Pugh scoring into stages A, B, and C of cirrhosis. A control group of healthy volunteers was included. After gastroenterologic clinical and laboratory examinations, all participants underwent a splenoportal Doppler sonographic evaluation in which the vessels' diameter, area, and blood flow velocity were measured and blood flow rate and the congestion index in the splenoportal venous system were calculated. RESULTS: Seventy-five patients with cirrhosis (25 women and 50 men) were enrolled; the control group consisted of 30 healthy volunteers (15 women and 15 men) with no liver disease. The mean age (+/- standard deviation) of the patients was 54.4 +/- 14.8 years (range, 13-80 years) and of the control subjects was 47.3 +/- 14.5 years (range, 18-72 years). No significant differences in vessel diameter, blood flow velocity, and blood flow rate were found in the main and left portal veins between the study group and the control group. In the right portal vein, we found decreases in the vessel diameter, blood flow velocity, and blood flow rate, and in the splenic vein, we found increases in vessel diameter and blood flow rate. The congestion index was increased in the main portal and splenic veins but was unchanged in the left portal vein. CONCLUSIONS: Although our data indicate that there is no difference in Doppler sonographic parameters of the main portal vein according to Child-Pugh scores, the hemodynamic differences between the left and right branches of the portal vein may be clinically useful in patients with cirrhosis.     

下肢静脉压和最大血流量对术后深静脉血栓形成的意义

目的 分析下肢静脉压和下肢静脉最大血流量在外科术后深静脉血栓形成的意义,以期早期诊断、早期护理,预防血栓形成.方法 收集术后高度怀疑有下肢深静脉血栓形成的患者167例,并进行下肢静脉压和下肢静脉最大血流量测定,数据作卡方检验和Logistic回归分析.结果 下肢静脉压和下肢静脉最大血流量与术后深静脉血栓形的关系,经卡方检验和Logistic回归分析,差异有统计学意义.结论 下肢静脉压和下肢静脉最大血流量可以作为临床发现下肢深静脉血栓的早期指标.     

Antenatal measurement of fetal umbilical venous flow by pulsed Doppler and B-mode ultrasonography

In this study, 163 normal fetuses of between 25 and 41 weeks' gestational age were examined sonographically using B-mode and Doppler equipment to measure umbilical vein diameter, umbilical venous flow amount (UVFA) and velocity (UVFV), and abdominal area (AA). A total number of 230 examinations were performed. The relationships between gestational age and umbilical vein diameter, UVFA, UVFV, and the UVFA/AA ratio were analyzed. Throughout pregnancy, the umbilical venous blood flow velocity remained relatively constant, whereas the umbilical venous blood flow amount increased steadily with gestational age and was proportional to abdominal area.     

Effects of graduated compression stockings with different pressure profiles on lower-limb venous structures and haemodynamics

INTRODUCTION: Graduated compression stockings (GCS) are one of the essential mechanical therapeutic approaches used in prevention and treatment of venous diseases. Pressure levels and gradient distribution are the two determined parameters influencing the performance of GCS products. However, the effects of GCS with different pressure profiles on venous function remain controversial in practical use. OBJECTIVE: To determine the physiological effects of GCS with different pressure levels and gradient distribution profiles on the venous function of the lower extremities. METHODS: At specific testing points along the long and short saphenous veins (LSV, SSV) and popliteal veins (PV) of the lower extremities, Doppler ultrasound techniques were used to examine venous cross-sectional areas (VA, cm(2)), the venous peak blood flow (PVpeak, cm/sec) and venous mean blood flow (PVmean, cm/sec) velocities in twelve female subjects wearing GCS with varying pressure profiles in a controlled laboratory environment. The Doppler examination was conducted three times during the 4-hour period (after wearing GCS for 1 minute, 70 minutes, and 170 minutes) in each subject. RESULTS: The pressure levels of GCS and duration of wear had statistically significant influences on the venous anatomy and venous haemodynamics. GCS with light, mild, moderate and strong pressures increased the popliteal PVpeak by 9.64%, 25.74%, 29.91% and 26.47%, respectively, and significantly decreased the VA. The GCS maintained these venous haemodynamics over time. No significant differences in blood flow were found between the mild, moderate and strong pressure GCS. CONCLUSION: The application of GCS with light and mild compression profiles appear to be effective in achieving a reduction in venous dilation and venous pooling, and improving venous return in the lower extremities. GCS with lighter pressures may be more suitable for subjects whose daily work requires long-term inactive standing or sitting, and GCS with mild pressure appear to be sufficient for most clinical applications.     

挤压泵对下肢深静脉血流动力学的影响

目的 探讨挤压泵对下肢静脉血流动力学的影响,从中筛选促进静脉血液回流的最佳模式。方法 用彩色多普勒超声检测10名20侧健康自愿受试者股静脉在平卧静息状态、踝关节主动伸屈运动、挤压泵6．0kPa（45mmHg）、挤压泵7．3kPa（55mrnHg）、挤压泵8．7kPa（65mmHg）5组状态下的股静脉血流峰速度、平均速度和单位时间血流量。结果 与平卧静息状态相比较,其余4种处理方法下,股静脉血流动力学指标都有显著性差异（P〈0．01）,其中,踝关节活动组增加最快,峰速度增加149％,平均速度增加148％,血流量增加1．18L／min,其次是挤压泵6．0kPa（45mmHg）,峰速度增加143％,平均速度增加144％,血流量增加1．15L/min,两组之间无统计学意义（P〉0．05）。踝关节运动组与挤压泵6．0kPa（45mmHg）组股静脉血流动力学指标均显著高于挤压泵7．3kPa（55mmHg）和挤压泵8．7kPa（65mmHg）组（P〈0．01）。结论 3种挤压泵模式中,挤压泵压力在6．0kPa（45mmHg）下促进静脉血液回流效果最佳,可以考虑作为临床术后患者预防深静脉血栓形成的护理措施之一。     

Umbilical vein blood flow in growth-restricted fetuses.

OBJECTIVE: To determine whether umbilical blood flow is reduced in a subset of growth-restricted (IUGR) fetuses when expressed as flow per kilogram or flow per unit of specific sonographic fetal measurements. DESIGN: Prospective. SUBJECTS: Thirty-seven IUGR fetuses were examined by Doppler ultrasound within 4 h of the last non-stress test prior to delivery. This population was divided into three groups of varying clinical severity according to the characteristics of umbilical arterial pulsatility index (PI) and heart rate. METHODS: Absolute and weight-specific umbilical vein (UV) flow were calculated from measurements of UV diameter and UV mean velocity. Umbilical vein diameter, velocity and UV flow were calculated also per unit head (HC) or abdominal circumference (AC) and correlated with gestational age. RESULTS: Umbilical vein flow (UVf) per kilogram fetal weight was significantly lower in the more severe IUGR fetuses (abnormal umbilical arterial PI) than in normally grown comparable fetuses (P < 0.001). Umbilical vein flow per unit HC was significantly lower in the three groups (P < 0.001) than in the control population. The UV diameter/HC ratio was normal whereas UV velocity/HC ratio was significantly lower in IUGR fetuses than in comparable controls. CONCLUSIONS: The present study clearly establishes that umbilical venous blood flow is reduced in IUGR fetuses on a weight-specific basis. The sonographic growth parameter which best distinguishes umbilical flow differences of IUGR fetuses from normal fetuses is the head circumference.     

腔镜深筋膜下交通支离断术对下肢静脉曲张性溃疡患者的临床效果

目的探索腔镜深筋膜下交通支离断术对下肢静脉曲张性溃疡患者的临床效果。方法选取102例下肢静脉曲张性溃疡患者为研究对象,根据手术方法分为观察组和对照组,各51例。对照组采用传统大隐静脉高位结扎、剥脱术治疗,观察组在传统高位结扎、剥脱基础上再进行腔镜深筋膜下交通支离断术治疗。观察两组患者3个月内复发率、患肢周径增长长度、患肢皮肤温度、血流速度及静脉血流峰速度。结果观察组3个月内复发率低于对照组(P<0.05)。观察组患肢周径增长长度短于对照组(P<0.05)。治疗后,观察组患肢皮肤温度、血流速度、静脉血流峰速度高于对照组(P<0.05)。结论对下肢静脉曲张性溃疡患者在传统高位结扎、剥脱术基础上实施腔镜深筋膜下交通支离断术治疗效果显著。     

经阴道彩超在髂股静脉血栓形成诊断中的应用

目的：探讨经阴道超检测髂股静脉血栓形成的应用价值。方法：应用7．5MHz经阴道彩色多普勒技术检查了40例正常成人和21例深静脉血栓患者的髂股静脉,对髂静脉内径、血栓部位、血流显示状况以及病因进行了综合分析。结果：与常规超声比较,明显改善了髂静脉的显示条件,血管显示率达100％。21例患者均在不同部位的髂股静脉内发现血栓斑块,静脉内径增或受压变窄,血流信号变细或消失,结论：对已婚妇女下肢静脉血栓的检查,常规超声加经阴道扫查应是临床诊断的首选方法。     

冠心病左心房局部功能的超声心动图评价

目的探讨应变率、速度图和位移图三种超声方法评价冠心病左心房局部功能的价值。方法应用常规超声心动图、应变率成像（SRI）、定量组织速度图（QTVI）和组织追踪显像（TTI）,分别测量20例正常人与14例左心房内径正常的冠心病患者左心房内径、二尖瓣口血流频谱E峰、A峰和E／A值以及右上肺静脉血流频谱S峰、D峰、A谷和A波持续时间（ADT）、左心房侧壁和房间隔的应变率、速度和位移变化。比较两组测量结果。结果两组左心房内径、二尖瓣口血流频谱值、肺静脉血流频谱值、速度和位移之间的差异均无显著性意义,而两组左心房侧壁和房间隔应变率之间的差异具有显著性意义（P〈0．05）。结论应变率成像能够在左心室舒张功能尚无明显改变的情况下,早期发现左心房局部功能的异常。