下肢静脉压测定在下肢深静脉血栓诊治中的临床应用

Clinical Application of Determination of Lower Extremity Venous Pressure in The Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis

目的探讨下肢静脉压在下肢深静脉血栓（DVT）诊治中的临床应用价值。方法选取2013年7月至2014年6月期间来笔者所在医院门诊并经彩色多普勒或下肢深静脉造影确诊的患有单侧下肢DVT患者90例作为研究对象（病例组）,其中男37例,女53例;年龄为18~84岁,平均年龄59.48岁;按病期分为急性期30例,亚急性期30例,慢性期30例;按病理类型分为央型30例,周围型30例,混合型30例。同时选取同期无下肢DVT的志愿者20例作为正常对照组,其中男9例,女11例,年龄为21~65岁,平均年龄38.7岁。测定2组纳入研究者的双下肢静态静脉压（P0）、动态静脉压（P00）和压力降低率（Pd）并进行比较分析。结果病例组不同病期以及不同病理类型的P0和P00均高于正常对照组（P〈0.01）,而Pd则低于正常对照组（P〈0.01）。病例组急性期的P0和P00均高于慢性期（P〈0.01）;中央型的P00高于周围型和混合型（P〈0.01）,中央型的Pd则低于混合型（P〈0.01）。正常对照组左右下肢的上述3项指标的差异均无统计学意义（P〉0.05）;病例组不同病期以及不同病理类型者患肢的P0和P00均高于健肢,而Pd则均低于健肢（P〈0.01）。结论下肢静脉压的测定可应用于临床对早期下肢DVT患者的检测,可作为临床对下肢DVT的治疗效果评估的客观指标,是一种简单实用的临床检测方法。

Objective To evaluate the value of clinical application of determination of lower venous pressure in the diagnosis and treatment of deep venous thrombosis （DVT）. Methods The 90 patients with DVT of unilateral lower limb who were admitted by using color Doppler or deep veins of lower limb angiography in our hospital during the period of 2013 July to 2014 June were selected and as the research object （case group）, 37 cases were male, 53 cases were female; the age was 18-84 years old, mean age was 59.48 years old. According to the development of disease, 90 cases were divided into acute 30 cases, subacute 30 cases, and chronic 30 cases; and according to the pathological types were divided into the central type in 30 cases, 30 cases of peripheral type, and 30 cases of mixed type. At the same time the without lower extremity DVT volunteers of 20 cases were selected as normal control group, including male 9 cases, female 11 cases; age was 21-65 years old, average age was 38.7 years old. The static venous pressure （P0）, dynamic venous pressure （P00）, and decreased pressure ratio （Pd） of double lower limbs of participants in 2 groups were determinated and comparative analyzed. Results The P0 and P00 of patients with different development of disease and pathological types of the case group were higher than those of the normal control group （P〈0.01）, and the Pd was lower than that of the normal control group （P〈0.01）. In case group, the P0 and P00 of acute phase were higher than those of the normal control group （P〈0.01）, the P0 of central type was higher than that of the peripheral type and mixed type （P〈0.01）, and the Pd central type was lower than that of mixed type （P〈0.01）. The above 3 indexes＇ differences of double lower limbs in the normal control group had no statistical significance （P〉O.O1）. In case group, the P0 and P00 of ipsilateral limb in different development of disease and pathological types were higher than those of the healthy limb, and the Pd were lower than that of the healthy limb （P〈0.01）. Conclusions Lower extremity venous pressure measurements can be used in clinical detection for early lower limb DVT, and can be used as the objective index of clinical evaluation curative effect for the treatment of DVT. It is a simple and practical clinical detection method.