创伤所致下肢深静脉漂浮血栓的超声表现与预后相关因素研究

Research of correlative factors between the ultrasonography of trauma-caused deep venous free-floating thrombus of lower limbs and the prognosis

目的分析创伤所致下肢深静脉漂浮血栓（free—floatingthrombus，FFT）的彩色多普勒声像图特点，探讨其与血栓预后的关系。方法回顾性分析130例创伤所致下肢深静脉FFT患者的临床资料和彩色多普勒声像图表现，将FFT部位、回声、边缘清晰度、漂浮程度以及FFT周围绕行血流与FFT再通或固定两种预后做单因素分析，将有统计学意义的变量进行非条件Logistic回归分析，分析FFT预后的独立影响因素。结果非条件Logistic回归分析显示FFT部位、边缘清晰度、漂浮程度和周围绕行血流多少是FFT预后的独立影响因素（P〈0．05）。髂股静脉部位的FFT预后为固定的可能性较胭静脉大，FFT边缘不清晰者预后为固定的可能性大，漂浮程度越明显者预后为再通的可能性大，血栓周围绕行血流多者预后为再通的可能性大。结论彩色多普勒超声可以评估下肢深静脉FFT与预后的关系，利于临床早发现早治疗，降低骨科围手术期深静脉血栓致死率及致残率。

Objective To analyze the color Doppler ultrasonography of trauma-caused deep venous free-floating thrombus（FFT） of lower limbs,discuss the relations between sonography and the prognosis. Methods Clinical data and color Doppler ultrasound examination results of 130 cases with trauma-caused deep venous FFT of lower limbs were retrospectively analysed. Univariate analysis was conducted to identify the statistically significant factors of patientsr prognosis, non conditional logistic regression analysis was performed to analyse the independent prognostic factors of FFT. Results The non-conditional logistic regression analysis showed that the position of FFT, thrombosis edge definition, floating degree and the volume of detouring blood around the thrombus were independent factors of patients~ prognosis（ P ~0.05）. The FFT prognosis of iliofemoral vein was more likely to be fixed than the FFT prognosis of popliteal vein. The FFT prognosis with blurring edges was more likely to be fixed. The more obvious the floating degree of FFT, the higher chance that the FFT prognosis is recanalized. More detouring blood flow around FFT indicated more possibilities that the prognosis could be recanalized. Conclusions The color Doppler ultrasound is able to evaluate the relations between the deep venous free-floating thrombus of lower limbs and prognosis of the patients,which is beneficial for early detection and early treatment,as well as reducing mortality and disability resulted from deep venous thrombus during the orthopaedic perioperative period.