全膝关节置换后下肢静脉血栓：完全加压超声联合彩色血流多普勒显像评估

Diagnostic value of complete compression ultrasound combined color Doppler flow imaging for deep vein thrombosis following total knee arthroplasty

目的:分析完全加压超声联合彩色血流多普勒显像对全膝关节置换后下肢深静脉血栓的诊断价值。方法:随机抽取2006-03/09择期行全膝关节初次置换患者42例59膝,其中左膝14例,右膝11例,双膝17例。均选用美国Depuy公司含庆大霉素骨水泥固定假体。置换后(13±2)d均由专人做双下肢完全加压超声联合彩色血流多普勒显像检查和静脉造影检查。结果:完全加压超声联合彩色血流多普勒显像检查共发现急性下肢深静脉血栓者12例,有症状者3例,其中单膝1例,双膝2例。血栓部位均在远端,其中左下肢者5例,右下肢者3例,双下肢者4例。静脉造影检查共发现急性下肢深静脉血栓者7例,有症状者3例,其中单膝1例,双膝2例;血栓部位均在远端,其中血栓部位在左下肢者3例,右下肢者2例,双下肢者2例。与静脉造影检查相比,完全加压超声联合彩色血流多普勒显像检查在下肢深静脉血栓的诊断方面,其精密度达到0.714,特异度为0.80。结论:采用完全加压超声联合彩色血流多普勒显像检查可以形成特定的声像资料,与静脉造影相比具有较高的特异性和灵敏度。

AIM： To evaluate the value of complete compression ultrasound （CCUS） combined color Doppler flow imaging （CDFI） in diagnosis of deep vein thrombosis following total knee arthroplasty （TKA）. METHODS： From March to September 2006, 42 patients （59 knees） undergoing primary TKA were randomly selected, including 14 patients with left knees, 11 with right knees and 17 with bilateral knees. The TKA was performed using Gentamicin-containing Depuy bone cement （USA）. The patients were excluded on days （13_＋2） postperatively by CCUS combined CDFI and venography. RESULTS： CCUS combined CDFI showed that 12 cases had acute deep vein thrombosis of lower limbs, and 3 were symptomatic （1 of unilateral knee and 2 of bilateral）. The thrombosis was located at distal site, including 5 in the left lower limb, 3 in the right, and 4 in the bilateral. Venography showed that 7 cases had acute deep vein thrombosis of lower limbs, and 3 were symptomatic （1 of unilateral knee and 2 of bilateral）. The thrombosis was located at distal site, including 3 in the left lower limb, 2 in the right, and 2 in the bilateral. Compared to venography, CCUS combined CDFI exhibited precision 0.714, and specificity 0.80 in diagnosing deep vein thrombosis of lower limbs. CONCLUSION： CCUS combined CDFI can form specific auditory image data, and exhibit higher sensitivity and specificity compared with venography.