彩色多普勒超声对脊髓损伤后并发肺动脉栓塞患者下肢静脉血栓的诊断价值

目的探讨彩色多普勒超声检查对脊髓损伤患者下肢深静脉血栓和肺栓塞的诊断价值。方法对60 例肺动脉栓塞患者(肺栓塞组)和同期35 例无肺栓塞的脊髓损伤住院患者(对照组)进行下肢静脉彩色多普勒超声检查。结果肺栓塞组中，36 例脊髓损伤患者，15 例检出下肢静脉血栓；24 例非脊髓损伤患者，9 例检出下肢静脉血栓。脊髓损伤患者与非脊髓损伤患者相比，两组肺栓塞发生率无显著性差异(P>0.05)。对照组有5 例检出下肢静脉血栓。肺栓塞组与对照组相比，下肢静脉血栓发生率有非常显著性差异(P<0.01)。肺栓塞组中，37 例急性肺栓塞患者，11 例检出下肢静脉血栓；23 例慢性肺栓塞患者，10 例检出下肢静脉血栓。两者检出率无显著性差异(P>0.05)。肺栓塞组中，31 例检出股静脉瓣反流和小腿肌肉间静脉扩张，检出率51.7%；对照组8 例检出，检出率22.9%。两组相比有非常显著性差异(P<0.01)。结论脊髓损伤后肺栓塞患者与非脊髓损伤肺栓塞患者的下肢静脉血栓检出率无明显差别，但均明显高于无肺栓塞的脊髓损伤患者。彩色多普勒超声检查下肢静脉对肺栓塞诊断具有临床价值。

Application of Color Doppler Ultrasound in Diagnosis of Deep Vein Thrombosis of Lower Limbs for Pulmonary Embolism following Spinal Cord Injury

Objective To study the value of color Doppler ultrasound in diagnosis of deep vein thrombosis (DVT) of lower extremity and pulmonary embolism (PE) in spinal cord injury (SCI). Methods 60 PE patients (PE group) and 35 SCI patients without PE (control group) received color Doppler ultrasound examination for DVT of lower extremity. Results PE group included 36 SCI patients (PE-SCI group) and 24 no-SCI patients (PE-no-SCI group). There were 15 cases with lower extremity thrombosis in PE-SCI group, and 9 cases in PE-no-SCI group (P>0.05), while there were 5 cases in the control group. There was significantly different in lower extremity thrombosis between PE group and the control group (P<0.01). In PE group, the detection rate was not significantly different between acute PE (detected 11 cases out of 37 cases) and chronic PE (detected 10 cases out of 23 cases) (P>0.05). 31 cases were rechecked as lower extremity venous valve regurgitation and calf muscle vein dilation (51.7%) in PE group while 8 cases in the control group (22.9%) (P<0.01). Conclusion There is not significantly different in the detection rate of DVT of lower extremity in PE patients with and without spinal cord injury, which are higher than in the patients without PE. Color Doppler ultrasound is necessary to check DVT in acute and chronic PE patients.