重症患者深静脉穿刺置管术后管腔内血栓的彩色多普勒超声检查监测应用研究

目的评价彩色多普勒超声检查对监测重症患者深静脉穿刺置管前后管腔内血栓形成的价值。方法选取在急诊重症监护室（EICU）住院凝血功能正常的深静脉穿刺置管患者7例，术前抽血测定C反应蛋白（CRP）、D-二聚体（D—Dimer）、血小板计数（PLT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTr）、血浆纤维蛋白原（FIB）、凝血酶时间（TT）。置管〉48h者在抽血复查CRP、D—Dimer、PLT、PT、APTT、FIB、TT且病情允许情况下，行B超检查监测深静脉穿刺管内管外是否有血栓形成，并取样送病理检查。评价超声检查在监测深静脉穿刺置管术后管腔内血栓的价值。结果7例患者静脉穿刺置管前后各项指标比较差异无统计学意义（P〉0．05）。6例超声检查见导管内血栓形成，经病理检查支持B超诊断。结论彩色多普勒超声检查对监测深静脉导管内血栓形成有较好的价值。

Appfication research on color Doppler flow imaging in monitoring the occurrence of intraductal thrombosis after deep venous catheterization in severe patients

Objective To investigate the effect of color Doppler flow imaging in monitoring the occurrence of intraduetal thrombosis after deep venous catheterization in severe patients. Methods Seven seriously ill patients with normal coagulantion function in EICU of the people＇ s hospital of Guangxi Zhuang Autonomous Region were chosen. CRP,D-D,PLT, PT, APTT, FIB and TT of patients were tested before deep venous puncture. 48 hours later, The aforementioned items were tested again and the deep venous catheters were monitored by eolour Doppler flow imaging. Suceessionally the deep venous catheters were pulled out and the intraductal thrombosis were tested by pathological examination. All the test results and the relevant factors of intraductal thrombosis after deep venous catheter was in- serted were statistically analysed. Results The intraductal thrombosis in 7 patients were verified through pathological examination after deep venous catheter were inserted. The statistical difference of the test result of CRP, D-D, PLT, PT,APTT, FIB,TT were not significant before and after deep venous venipuncture （ P 〉 0. 05 ）. yet, the intraduetal thrombosis in 6 patients could be monitored by color Doppler flow imaging. Conduslon It is a good means to use Doppler flow imaging to monitor the occurrence of intraductal thrombosis in deep venous catheterization.