彩色多普勒超声在下肢肌间静脉血栓中的诊断价值研究

目的探讨彩色多普勒超声诊断下肢肌间静脉血栓的临床价值。方法108例疑似下肢肌间静脉血栓患者,均进行彩色多普勒超声检查。以后期手术及静脉造影结果作为金标准,观察彩色多普勒超声检查的诊断效能及对不同时期血栓的诊断结果。结果108例疑似患者经后期手术或静脉造影确诊下肢肌间静脉血栓80例,彩色多普勒超声确诊78例患者,误诊6例,其中静脉炎3例,静脉瓣膜2例,其他1例,漏诊2例,彩色多普勒超声检查的敏感度为97.5%、特异度为78.6%、准确度为92.6%。80例确诊患者中急性期血栓56例,陈旧性血栓24例,无法判断0例;彩色多普勒超声检查结果中急性期血栓47例,陈旧性血栓24例,无法判断7例,彩色多普勒超声对于陈旧性血栓的诊断准确率为100.0%(24/24),高于急性期血栓的83.9%(47/56),差异具有统计学意义(P<0.05)。结论彩色多普勒超声对于下肢肌间静脉血栓的诊断效果良好,可明确观察血栓位置及形态,为临床治疗提供依据,并且超声检查经济无创,可作为下肢肌间静脉血栓诊断的首选检查方式。

Diagnostic value of color Doppler ultrasound in calf muscular venous thrombosis of lower extremity

Objective To discuss the clinical value of color Doppler ultrasound in calf muscular venous thrombosis of lower extremity.Methods Color Doppler ultrasound was performed in 108 patients with suspected calf muscular venous thrombosis of lower extremity.The results of later operation and venography were used as the gold standard to observe the diagnostic efficiency of color Doppler ultrasound and the diagnosis results of thrombosis in different periods.Results Among 108 suspected patients,80 cases were diagnosed as calf muscular venous thrombosis of lower extremity by late operation or venography,78 cases were diagnosed by color Doppler ultrasound,6 cases were misdiagnosed,including 3 cases of phlebitis,2 cases of venous valve,1 case of other cases,and 2 cases of missed diagnosis.The sensitivity,specificity and accuracy of color Doppler ultrasound examination were 97.5%,78.6%and 92.6%respectively.In 80 cases,56 cases were acute thrombosis,24 cases were old thrombosis,and 0 case could not be judged;in the results of color Doppler ultrasound,47 cases were acute thrombosis,24 cases were old thrombosis,and 7 cases could not be judged.The diagnostic accuracy rate of color Doppler ultrasound for old thrombosis was 100.0%(24/24),which was higher than 83.9%(47/56)of acute thrombosis,and the difference was statistically significant(P<0.05).Conclusion Color Doppler ultrasound has a good effect in the diagnosis of calf muscular venous thrombosis of lower extremity.It can clearly observe the location and morphology of thrombus,provide a basis for the later treatment of clinicians.Moreover,ultrasound examination is economical and noninvasive,which can be used as the preferred examination method for the diagnosis of calf muscular venous thrombosis of lower extremity.