骨科大手术后下肢深静脉血栓形成的床旁彩色多普勒超声诊断

BEDSIDE CDFI DIAGNOSIS OF THROMBOSIS OF DEEP VEIN AFTER MAJOR ORTHOPEDIC OPERATION

目的应用床旁彩色多普勒超声检查，对骨科大手术后下肢深静脉血栓形成作出早期诊断，便于临床及时采取有效治疗措施，防止肺栓塞的发生。方法回顾性总结我院2004年7月～2006年10月骨科大手术后1周、2周、1月下肢深静脉血栓形成的发生情况。结果538例病人术后有160例检出下肢深静脉血栓形成，发生率为29．7％，其中术后1周、2周、1个月发生率分别为17．8％、11．2％、6．1％；胫后静脉及肌内分支占75．6％，其中健侧肢体发生血栓者为8．8％；60岁以上人群发生率为43．4％，40岁以下发生率为10．1％，最小年龄为21岁。结论骨科大手术后下肢深静脉血栓形成发生率高，以手术后1周内发生率较高。彩色多普勒超声对骨科大手术后下肢深静脉血栓形成的诊断敏感性高、特异性强，便于床旁操作。

Objective To make an early diagnosis of deep venous thrombosis of lower limb after major orthopedic opera tion by bedside CDFI, and promptly take effective measure to prevent pulmonary embolism. Methods A retrospective summary was done for deep venous thrombosis of lower limb occurred at one week, two weeks, and one month after major orthopedic procedure done from July 2004 to October 2006. Results Of 538 cases reviewed, deep venous thrombosis was found in 160 patients （29.7%）, in which, the one-week, two-week, and one-month incidence after surgery was 17.8G, 11.2%, and 6.1%, respectively. The posterior tibial veins and intramuscular branches were involved in 75. 6%, in which, the uninjured side accounted for 8.8%. The incidence was 43.4% for those over 60 years old, 10.1 % below 40; and the youngest was 21. Conclusion The inci dence of deep venous thrombosis after major bone surgery is high, especially within one week. CDFI has high sensitivity and specificity in the diagnosis of deep venous thrombosis and is easy to be operated bedside.