超声评估老年下肢深静脉血栓的临床价值

Clinical value of ultrasonic evaluation in elderly patients with deep vein thrombosis of lower extremities

目的探讨超声诊断老年下肢深静脉血栓的准确性,同时分析老年下肢深静脉血栓的超声特征。方法选取2017年1月至2017年10月我院行下肢深静脉超声检查的患者30例,以X线静脉造影检查作为金标准,观察下肢静脉血栓形态、发生部位、回声特点及血流动力学特征。结果 30例患者中,超声检测出11例下肢深静脉血栓患者,灵敏度为91.67%(11/12),特异度为100.00%(18/18),准确性96.67%(29/30)。急性期超声特点显示:血栓部位管径明显增宽,血管内壁清晰可见,均呈现低回声,血栓部位血流量充盈缺损。亚急性期:血管管径粗细不一,血栓呈强回声、等回声,血流量充盈缺损。慢性期:血管管径变小或趋向正常,血栓部位呈现等回声或较高回声,血流量趋向正常。结论超声诊断老年下肢深静脉血栓具有高的准确性,诊断时应结合患者超声特点进行判断,对临床医师制定相应治疗方案提供可靠的参考依据。

Objective To discuss the accuracy of ultrasonic evaluation in elderly patients with deep vein thrombosis of lower extremities and analyzed ultrasonic characteristics of elderly deep vein thrombosis of lower extremities. Methods Thirty patients with deep vein thrombosis ultrasound of lower extremities from January 2017 to October 2017 in our hospital were selected, the X-ray angiography as a golden standard, the venous thrombosis form of the lower extremity,its location, echo characteristics and hemodynamics characteristics were observed. Results Of the 30 patients, 11 patients with deep venous thrombosis of lower extremity were detected by ultrasound, with a sensitivity of 91.67%（11/12）,specificity of 100.00%（18/18） and accuracy of 96.67%（29/30）. Acute phase ultrasonic characteristics showed that thrombus tube diameter significantly broadened, the lining of blood vessels could be clearly seen and low echo, blood flow was filling and defect in thrombus. Subacute period： vascular diameter thickness was differ and there was strong echo, equal echo, blood flow was filling and defect in thrombus. Chronic phase： vascular diameter became smaller or more normal, there was equal echo or higher echo at thrombus sites, blood flow rate was more normal. Conclusion Ultrasound diagnosis in the diagnosis of deep vein thrombosis of lower extremities in elderly patients has high accuracy,the diagnosis should be judged with ultrasound characteristics of patients, to provide reliable reference basis of the corresponding treatment for clinical doctors.