超声在观察宫颈癌术后放疗患者下肢静脉血栓形成中的应用

Application of ultrasound in the observation of thrombogenesis in the lower limb veins of cervical cancer patients after postoperative radiotherapy

目的探讨超声在观察宫颈癌术后放疗患者下肢静脉血栓形成中的应用价值。方法选取宫颈癌术后放疗并确诊为下肢静脉血栓的患者94例作为实验组，再根据血栓形成时间将实验组分为急性血栓组、亚急性血栓组及慢性血栓组；选择同期住院的宫颈癌术后放疗不伴有下肢静脉血栓的患者154例作为对照组，对比观察实验组及对照组所有患者下肢静脉血管内径、管腔内回声及血流充盈情况等。结果急性血栓组患者下肢病变静脉管径较对照组明显增宽（P〈0．05）。管腔内呈低回声或无回声，彩色多普勒血流显示未见明显血流信号或出现血流充盈缺损；亚急性血栓组个别患者病变下肢静脉管径缩小，与急性血栓组比较，差异无统计学意义。管腔内低回声有所增强，血流出现不同程度的再通；慢性血栓组患者下肢病变静脉内径较急性血栓组明显减小（P〈0．05）。管腔内血栓回声较之前明显增强，CDFI显示血流呈“轨道征”。结论超声对宫颈癌术后放疗患者下肢静脉血栓有较高的诊断价值，可以确定血栓的发生部位、类型，测定病变血管的内径并观察血流情况。

Objective To explore the application of ultrasound to observe the thrombogenesis in the lower limb veins of cervical cancer patients after postoperative radiotherapy. Methods A total of 94 cervical cancer patients diagnosed with thrombosis in the lower limbs after postoperative radiotherapy were selected as an experiment group, who were then divided into an acute thrombus group, a subacute thrombus group and a chronic thrombus group, according to the forma- tion time of thrombus. Meanwhile, another 154 cervical cancer patients without thrombosis in the lower limbs after post- operative radiotherapy were enrolled as a control group. Both groups were compared for the internal diameter of the lower limb veins, intra - luminal echo signal and blood flow. Results The acute thrombus group had a notably wider internal diameter in the diseased lower limb veins than the control group （ P 〈 0.05 ）. No or low intra - luminal echo signal was found. According to color Doppler, no obvious blood flow signal or blood - flow filling defects were found. The subgroup thrombus group had a narrower internal diameter in the diseased lower limb veins, which however was not statistical dif- ferent from those of the acute thrombus group. Low intra - luminal echo signal was strengthened, and blood flow was ob- served to various degrees. The chronic thrombus group showed remarkably decreases in the internal diameter of the dis- eased lower limb veins compared with the acute thrombus group （P 〈 O. 05）, with obviously strengthened intra - luminal echo signal and orbital blood flow. Conclusions Ultrasound is useful to diagnose the thrombosis in the lower limbs of cervical cancer patients after postoperative radiotherapy, which can determine the location and type of thrombi, measure the internal diameter of diseased vessels and observe blood flow.