彩色多普勒超声检查在急性肺栓塞诊断与治疗中的价值

The significance of color Doppler echocardiography and deep venous color Doppler ultrasonography in the diagnosis and treatment of acute pulmonang embolism

目的探讨彩色多普勒超声在急性肺栓塞诊断与治疗中的价值。方法对临床综合诊断(包括核素肺灌注扫描、MRI及肺动脉造影)为急性肺栓塞患者30例所进行的彩色多普勒超声心动图及周围血管彩色多普勒超声检查。结果超声心动图检出肺动脉分叉处血栓2例,右心异常改变者21例,其中右室增大伴右室收缩功能减退17例,右室肥厚15例,室间隔运动幅度减低17例,右房增大15例,肺动脉扩张6例。彩色多普勒血流显像在16例患者取得中度至重度三尖瓣反流,用连续多普勒测量三尖瓣反流速度,估测肺动脉收缩压,16例患者肺动脉压升高,范围32～105mmHg(63.5±21.09)mmHg,治疗后肺动脉压明显下降,25.0～55.7(39.6±12.16)mmHg。下肢深静脉彩色多普勒超声检查12例患者检出深静脉血栓,6例血流缓慢伴自发性云雾样回声。结论系统全面、动态的彩色多普勒超声心动图及周围血管彩色多普勒超声检查,对于急性肺栓塞患者的诊断的确立、疗效的评估均有重要价值。

Objective To evaluate the feasibility and clinical value of color Doppler echocardiography and deep venous color Doppler ultrasonography in the diagnosis and treatment of acute pulmonary embolism. Methods Thirty consecutive patients with acute pulmonary embolism underwent color Doppler echocardiography and deep venous color Doppler ultrasonography. Results Thrombus within the pulmonary artery was detected in 2 patients, right ventricular dysfunction was found in 21 patients, pulmonary hypertension was found in 16 patients, and proximal vein thrombosis was detected in 12 patients, SEC in 6 patients. Conclusion Color Doppler echocardiography and deep venous color Doppler ultrasonography plays an important roles in improving the sensitivity and specificity in the diagnosis and treatment of acute pulmonary embolism.