肢体动脉急慢性闭塞的彩色多普勒超声诊断

Color Doppler ultrasonography in the diagonosis of acute and chronic artery occlusion of the extremities

目的研究彩色多普勒超声诊断肢体动脉急慢性闭塞的临床价值。方法回顾性分析北京安贞医院血管外科2006--2010年收治的129例肢体动脉闭塞患者的临床资料，其中男性85例，女44例，年龄为17～94岁，平均（62±9）岁。分析39条急性闭塞动脉和97条慢性闭塞动脉的二维、彩色多普勒超声结果，对两组闭塞段管腔内回声、管壁结构、闭塞近远段血流动力学参数及侧支动脉进行对比。结果急慢性动脉闭塞在闭塞段管壁厚度、内径、闭塞近段阻力指数和侧支动脉方面有统计学意义（P〈0．05）。急性动脉闭塞段内径大于慢性闭塞段，而管壁厚度、闭塞近段阻力指数和侧支动脉明显小于慢性闭塞段。超声诊断急慢性动脉闭塞的准确率是95．6％。结论彩色多普勒超声是鉴别肢体动脉急慢性闭塞有价值的检查手段，能够为临床诊断和手术治疗提供客观依据。

Objective To investigate the clinical value of color Doppler uhrasound examination in the diagonosis of acute and chronic artery occlusion of the extremities. Methods A review was made on 129 extremetiy artery occlusion patients at Anzhen Hospital during 2006 -2010. 85 cases were male, and 44 cases were female. Age was from 17 to 94 years （average.. 62 ± 9 years）. We analyzed two-dimensional and color Doppler flow imagings of 39 acute occlusion arteries and 97 chronic occlusion arteries. We compared factors including the echoes of artery lumens, the vessel wall structures, hemodynamic parameters of inlet and outlet at the occlusion, and collaterals between groups. Results The factors of depths of vessel wall, internal diameters of ccclusion arteries, proximal resistant index and collaterals were significantly different between groups （ P 〈 0.05 ）. The internal diameters of acute ccclusion arteries were wider than chronic occlusion arteries. The depths of vessel wall, proximal resistant index and collaterals were thinner, smaller, and less than chronic occlusion arteries. The total accurate rate of differential diagnosis for acute and chronic artery occlusion by color Doppler ultrasound was 95.6%. Conclusions Color Doppler ultrasound is an effective method for the differential diagnosis of acute and chronic artery occlusion of the extremities.