修正Geneva评分联合超声对肺栓塞的诊断价值分析

Value Analysis of Revised Geneva Scores Combined Ultrasonography to the Diagnosis of Pulmonary Throm boem bolism

目的:分析修正Geneva评分联合心脏超声以及下肢深静脉超声对肺栓塞的诊断价值。方法:可疑肺栓塞患者经过CTPA检查后分为肺栓塞组与非肺栓塞组,并对每位可疑肺栓塞患者进行修正Geneva评分、心脏超声、下肢深静脉超声检查。应用诊断试验中比较常用的评价指标分析单项检查以及联合检查在肺栓塞诊断中的价值。结果:修正Geneva评分高度可能的阳性似然比大于10,阳性预测值为97.1%。三项检查均为阴性时,阴性似然比<0.1。下肢深静脉超声,修正Geneva评分高度可能联合下肢深静脉超声的Youden指数均大于0.6,对肺栓塞的诊断具有重要的提示意义。检查项目之间的联合可提高诊断的灵敏度。结论:修正Geneva评分高度可能对肺栓塞的诊断具有较为准确的预测价值。修正Geneva评分、心脏超声、下肢深静脉超声三者结合是一种快速、无创、廉价、安全且实用的筛查可疑肺栓塞患者的诊断策略。

Objective： To analysis the value of revised Geneva scores combined transthoracic echocardiography and lower extremity deep vein nhrasound for diagnosis of pulmonary embolism （ PE ） .Method： Patients with suspected pulmonary embolism after CTPA examination are divided into pulmonary embolism group and the non-puhnonary embolism group, and to each of the patients with suspected pulmonary embolism revised Geneva score, echocardiography and lower extremity deep vein ultrasound examination.The application of diagnostic test are widely used in the evaluation index analysis single inspection and joint inspection in the diagnostic value of pulmonary embolism.Result： Revised Geneva score highly possible positive likelihood ratio is more than 10, the positie predictie alue was 97.1%.Three inspection are negative, negative likelihood ratio 〈0.1.Lower extremity deep vein ultrasound and revised Geneva score highly possible joint lower extremity deep vein ultrasonic Youden index 〉0.6, for the diagnosis of puhnonary embolism has important tip significance.Jiont inspection items can improve the diagnostic sensitivity.Conclusion： Revised Geneva score highly likely has more accurate predictive value for the diagnosis of pulmonary embolism.Revised Geneva scores, transthoracic echocardiography, lower extremity deep vein uhrasound of the three is a fast, noninvasive, cheap, safe and practical screening diagnostic strategy for patients with suspected pulmonary embolism.