彩色多普勒超声在中央型血栓诊断与介入治疗中的应用价值

目的 探讨彩色多普勒超声（CDUS）在急性中央型血栓诊断中的价值及在介入治疗中的意义。方法 回顾性分析2014年1月至2016年1月蚌埠医学院第一附属医院收治的32例急性中央型血栓患者的临床资料，所有患者入院后先行下肢CDUS检查，DSA进一步明确诊断后，在滤器保护下借助超声引导穿刺腘静脉为入路行深静脉置管溶栓术，观察下肢肿胀消退情况并复查CDUS，评估血管再通情况。结果 本组32例患者入院超声检查与DSA结果一致，均诊断为急性中央型血栓，经溶栓治疗，下肢肿胀均较治疗前显著缓解，平均管腔直径狭窄率（38.28±2.37）%较术前（90.19±2.58）%降低，差异有统计学意义（P<0.05），治疗有效率达100%。结论 CDUS在急性中央型血栓诊断中敏感性高，同时具有无创、可反复的优点，可作为诊断该疾病的首选方法之一，在超声引导下穿刺行置管溶栓及疗效评价中具有明显优势。

Application of color Doppler ultrasound in diagnosis and interventional treatment of central thrombosis

Objective To investigate the application value of color Doppler ultrasound (CDUS) in the diagnosis and interventional treatment of acute central deep venous thrombosis in the lower extremity.Methods The clinical data of 32 patients with acute central deep vein thrombosis, ever treated in our hospitals from Jan 2014 to Jan 2016, were retrospectively analyzed.All patients were detected in the lower limb first by CDUS and further diagnosed by DSA, and underwent the catheter-directed thrombolysis (CDT) of popliteal vein via ultrasound-guided venipuncture under the protection of inferior vena cava filter.After operation, regression of the lower limb swelling was observed, and recanalization of the lower limb thrombosis was again detected by CDUS.Results The imaging results of CDUS and DSA in these 32 patients were consistent at hospitalization, and both diagnoses were acute central thrombosis in the lower extremity.After CDT treatment, the lower limb swelling was much alleviated than before, and the average stenosis rate of lumen diameter (38.28±2.37)% was significantly reduced when compared with the preoperative result (90.19±22.58)% (P<0.05).The total effective rate of CDT treatment was 100%.Conclusion Application of CDUS imaging in the diagnosis of acute central thrombosis has the advantage of high sensitivity, noninvasive and repeatable, and could be used as one of the first choice for diagnosis.The CDT treatment of deep vein via ultrasound-guided venipuncture would be superior on the curative effect evaluation.