双功多普勒彩超诊断慢性下肢静脉功能不全的临床意义

Clinical Significance of Duplex Ultrasonography in the Diagnosis of Chronic Venous Insufficiency

目的对照下肢静脉顺行造影,研究双功多普勒彩超诊断慢性下肢静脉功能不全的意义。方法应用双功多普勒彩超和下肢静脉顺行造影,检查慢性下肢静脉功能不全108人126侧肢体,对照二者,判断深静脉和交通静脉返流以及交通静脉定位情况,分析双功多普勒彩超诊断慢性下肢静脉功能不全的正确率和优缺点。结果与下肢静脉顺行造影结果相比,双功彩超判断深静脉瓣膜逆流的完全符合率为50.8%,基本符合率达69.8%。63.7%的交通静脉同时被超声和造影检出,双功彩超能精确定位交通静脉,对交通静脉的漏诊率(11.7%)明显低于顺行造影(24.6%)。结论双功多普勒彩超无创、方便、准确,可重复多次检查,有可能取代静脉造影,成为下肢慢性静脉功能不全的术前常规检查。

Objective To investgate the significance of Duplex ultrasonography in the diagnosis of chronic venous insufficiency of lower limbs in comparision with ascending phlebography. Methods One hundred and eight patients with 126 lower limbs undergone Duplex ultrasonography and ascending phlebography plus Valsalva test and their findings were compared to estimate the reflux of deep vein and perforating vein and the orientation of perforating vein, and to analyse the accuracy and advantages and shortcomings of Duplex ultrasonography in the diagnosis of chronic venous insufficiency of lower limbs. Results In estimation of the deep venous reflux, 50. 8% results of Duplex ultrasonography were totally in accordance with ascending phlebography,and 69.8% were basically in accordance. A total of 63.7% perforating veins were checked out by Duplex ultrasonography and ascending phlebography together. Duplex ultrasonography could precisely orient the perforating veins, its undetected rate was 11. 7% , significantly lower than that of ascending phlebography (24. 6% ). Conclusion Duplex ultrasonography is a non-traumatic examination with advantages of convenience, accuracy and repeatability. It may replace ascending phlebography as the routine examination before operation on chronic venous insufficiency.