下肢深静脉血栓并发肺栓塞的彩色超声心动图诊断及其危险因素分析

Diagnosis and risk factors of pulmonary embolism complicated by lower extremity deep venous thrombosis by color Doppler echocardiography

目的:探讨下肢深静脉血栓并发肺栓塞的彩色超声心动图诊断价值及其危险因素。方法:选择2012-04~2015-03因下肢浮肿在我院住院的79例下肢深静脉血栓患者为研究对象,将经螺旋CT增强肺扫描和肺动脉造影证实并发肺栓塞的32例患者纳入观察组,无肺栓塞的47例患者纳入对照组。对确诊下肢深静脉血栓并发肺栓塞的患者行彩色超声心动图检查,探讨其临床诊断价值,对比两组患者年龄、性别、吸烟史、外伤手术史、肿瘤、高脂血症、糖尿病等可能的相关危险因素。结果:经彩色超声心动图检查,发现肺栓塞直接征象3例、间接征象29例;经下肢深静脉彩色多普勒超声检查,发现下肢深静脉血栓16例、下肢深静脉血流瘀滞10例。年龄超过60岁,有外伤手术史,患肿瘤、糖尿病者发生下肢深静脉血栓并发肺栓塞危险更高,是其发生的危险因素。结论:彩色超声心动图发现肺栓塞的间接征象概率较高,联合下肢静脉超声检查可提高对下肢深静脉血栓并发肺栓塞的诊断。年龄>60岁、外伤手术史、肿瘤、糖尿病是其发生的独立危险因素。

Objective:To investigate the value of color Doppler echocardiography in diagnosis of pulmonary embolism(PE)complicated by lower extremity deep venous thrombosis(LEDVT)and its risk factors.Methods:Seventy-nine cases of lower extremity deep venous thrombosis were chosen for the study,32 PE patients in observation group were confirmed by enhanced spiral CT lung scans and pulmonary angiography,control group included 47 patients without PE.Echocardiography examination was conducted in 32 patients who were diagnosed as pulmonary embolism complicated by LEDVT.We observed possible risk factors in different group,such as age,gender,smoking history,history of surgery,tumor,hyperlipidemia and diabetes.Results:Echocardiographic examination showed that direct signs of PE in3 cases,indirect signs of PE in 29 cases.It was found that LEDVT in 16 cases,lower extremity deep venous stasis in 10 cases.The following factors:>60years old,trauma surgery history,tumor,and diabetes are the risk factors for occurrence of pulmonary embolism complicated by LEDVT.Conclusion:Echocardiograph examination have a higher probability of finding pulmonary embolism indirect signs.Combined with lower extremity venous ultrasound examination could improve the diagnosis of pulmonary embolism in patients with LEDVT.Over the age of 60,trauma surgery,tumor,diabetes are the independent risk factors for its occurrence.