超声参数静脉管腔横截周长的平方与面积的比值对骨科住院 患者下肢深静脉血栓的预测价值

目的 应用超声测量静脉管腔横截周长(C)、面积(A)，计算C²/A，探讨该参数对骨科住院患者下肢深静脉血栓的预测价值。方法 选取于我院骨科拟行手术的无血栓住院患者150例，其中术后7 d内发生血栓37例(血栓组)，未发生血栓113例(无血栓组)；比较两组术前超声参数包括股总静脉(CFV)、股静脉(FV)、腘静脉(POV)C、A、C²/A、流速及内径的差异；绘制受试者工作特征(ROC)曲线分析CFV、FV、POV各超声参数预测下肢深静脉血栓的诊断效能。结果 与无血栓组比较，血栓组CFV内径、CFV-C、CFV-C²/A、FV-C、FV-C²/A、POV-C、POV-A和POV-C²/A均增加，差异均有统计学意义(均P<0.05)。ROC曲线分析显示，当CFV-C²/A、FV-C²/A、POV-C²/A截断值分别为>17.2、17.1、17.1，预测下肢深静脉血栓的曲线下面积分别为0.95395%可信区...

Evaluation the value of early venous changes of lower extremity before deep vein thrombosis by ultrasonic parameters in orthopedic patients

Objective Conventional ultrasonic measuring diameter and velocity of the vein to evaluate early venous tension changes of lower extremity deep vein thrombosis (DVT) with poor accuracy and repeatability. By applying the ratio cross-sectional perimeter2/cross-sectional area (C2/A) of common femoral vein(CFV), superficial femoral vein (SFV) and popliteal vein (POV) to evaluate DVT early vein tension change, discuss cut-off value method and diagnostic value of the C2/A preliminarily. Methods 150 patients in orthopedic without DVT underwent duplex ultrasound scan were studied. The value of venous flow velocity, Internal diameter, cross-sectional area(A), cross-sectional perimeter (C) and the ratio of C2/A of CFV, SFV and POV were recorded. The incidence of DVT were monitored by ultrasound after surgery and compared the value of the new parameter of C2/A before DVT occured. P<0.05 was considered statistically significant. Results There were significant differences in CFV inner diameter, CFV-C, CFV-A, CFV-C2/A, SFV-C, SFV-C2/A, POV-C, POV-A and POV-C2/A between the DVT group (24.70%) and the non-DVT group (75.30%) (all P<0.05). Area under curve (AUC) for CFV-C2/A, SFV-C2/A, and POV-C2/A as followed: 0.939 (95%CI: 0.888 -0.972, P<0.001), 0.937 (95%CI: 0.886 -0.970, P<0.001), and 0.917 (95%CI: 0.861-0.956, P<0.001), respectively; sensitivity 91.7%, 94.6%, and 91.9% , respectively; specificity 97.4%, 95.6%, and 93.8%, respectively. Conclusion The ratio of C2/A has high value in predicting thrombosis, and the interference factors are relatively less. It is providing new thinking and reference for intervention for clinical preventing DVT early.