二维及彩色多普勒超声对孕产妇下肢静脉病变的观察

Observation on changes of lower-limb veins in women before and after delivery by two-dimensional ultrasound and color Doppler flow imaging

目的:观察孕、产妇下肢静脉的变化,探讨妊娠期、产褥期下肢静脉血栓形成的病因、发生率及彩色多普勒超声诊断的应用价值.方法:利用二维及彩色多普勒超声测量96例孕、产妇不同时期的股静脉及大、小隐静脉的内径,观察血管内血流自显影、有无血栓及彩色多普勒血流显像情况.结果:随着孕龄增加,下肢静脉内径逐渐增宽,大隐静脉表现最为显著(P<0.05).中、晚孕期,股静脉内血流自显影发生率较高(中孕39.1%,晚孕92.5%).产后3mo内是下肢静脉血栓最易形成阶段.结论:孕妇下肢静脉压的升高导致了下肢静脉扩张,血流淤积,成为静脉血栓形成的易发因素.超声检查可安全、快速地了解孕妇妊娠期下肢静脉的功能变化,为临床的预防和治疗措施提供有价值的信息.

AIM： To observe the changes of the lower-limb venous system of women before and after delivery, to explore the causes and incidence of the lower-limb venous thrombosis during gestation and puerperium, and to discuss the diagnostic value of two-dimensional（2-D） ultrasound and color Doppler flow image （CDFI）. METHODS ： Ninety-six pregnant and postpartum women were recruited for the study. Femoral veins, great saphenous veins and small saphenous veins were assessed in both lower limbs using 2-D ultrasound and CDFI. The diameters were measured. The spontaneous blood flow echogenicity, venous thrombosis and reflux were observed in each vein. RESULTS： All veins dilated with increasing gestation. The diameters of the great saphenous veins increased significantly （ P 〈 0.05 ）. Spontaneous blood flow echogenicity in the femoral veins was clearly visible and marked in 39.1% of cases during the second trimester of pregnancy and 92.5% during the third trimester. The vein thrombosis was formed most easily within 3 months after delivery. CONCLUSION： The increase in lower-limb venous pressure during pregnancy leads to venous distention and worsens blood stasis. The examination by ultrasound diagnosis can demonstrate the situation of lower-limb veins safely and quickly, and can give more valuable information for clinical prevention and treatment.