股骨头坏死介入治疗前后孤立性小腿肌间静脉丛血栓超声检测的临床价值

The clinical value of ultrasonography in diagnosis of isolated calf muscular venous thrombosis in femoral head osteonecrosis patients during pre and post interventional therapy

目的探讨彩色多普勒超声在股骨头坏死介入治疗前后孤立性小腿肌间静脉丛血栓中的临床应用价值。方法以股骨头坏死介入治疗前后下肢静脉超声检出深静脉血栓137例患者为研究对象,着重分析其中孤立性小腿肌间静脉丛血栓的特点。结果孤立性小腿肌间静脉丛血栓69例(50.4%),单肢病变56例(81.2%),其中左侧29例(51.8%),右侧27例(48.2%),双肢病变13例(18.8%);共156处肌间静脉丛血栓,其中比目鱼肌间静脉丛血栓111处(71.2%),血栓直径为(8.5±2.8)mm,累及长度为(4.2±1.1)cm;腓肠肌间静脉丛血栓45处(28.8%),血栓直径为(7.1±1.9)mm,累及长度为(2.1±0.7)cm,比目鱼肌血栓直径及累及长度均大于腓肠肌(P<0.05);急性期和慢性期血栓声像图特点不同,69例患者中47例符合急性期血栓声像图特点,治疗后超声复查21例完全再通,26例部分再通;22例符合慢性期血栓声像图特点,复查后无明显变化。结论彩色多普勒超声可准确判断血栓发生的部位、数量、时期、累及范围,超声复查亦简便易行,为临床治疗及疗效评估提供可靠依据,是诊断股骨头坏死介入治疗前后并发孤立性小腿肌间静脉血栓的首选方法。

ObjectiveTo explore the clinical value of color Doppler ultrasonography in diagnosis of isolated calf muscular venous thrombosis in femoral head osteonecrosis patients during pre- and post- interventional therapy.Method137 femoral head osteonecrosis patients with deep venous thrombosis diagnosed by color Doppler ultrasonography during pre- and post- interventional therapy were chose as research objects. Features of isolated calf muscular venous thrombosis were mainly analyzed.ResultAmong 137 cases, 69 cases （50.4%） were diagnosed as isolated calf muscular venous thrombosis, 56 cases （81.2%） were unilateral limb lesions, including 29 left limbs and 27 right limbs. 13 cases （18.8%） were bilateral limb lesions; there were 156 cases of muscular venous thrombosis in total, in which 111 cases （71.2%） were soleus venous thrombosis, the diameter of thrombosis was （8.5±2.8） mm and length was （4.2±1.1） cm; in which 45 cases （28.8%） were gastrocnemius venous thrombosis, the diameter of thrombosis was （7.1±1.9 ） mm and length was （2.1±0.7） cm. The diameter and length of thrombosis in soleus were greater than those in gastrocnemius （P〈0.05）; there were different sonogram features between acute thrombosis and chronic thrombosis, 47 of 69 cases were diagosed as acute thrombosis, among whom 21 cases were completely recanalized and 26 cases were partialy recanalized after treatment; 22 of 69 cases were diagosed as chronic thrombosis with no obvious changes after treatment.ConclusionColor Doppler ultrasonography can accurately judge the parts, quantity, period and scope of the thrombosis. The follow-up ultrasound is simple, and provide a reliable basis for clinical treatment. Color doppler ultrasonography is a priority method to diagnose isolated calf muscular venous thrombosis in femoral head osteonecrosis patients.