下肢深静脉血栓形成超声特征及危险因素分析

Ultrasonographic Features and Risk Factors of Deep Venous Thrombosis of Lower Extremity

目的探讨下肢深静脉血栓形成(lower extremity deep venous thrombosis,LEDVT)患者超声特征及危险因素。方法选取2019年1—12月我院收治的经彩超确诊的156例LEDVT患者作为观察组,另选取同期来我院体检中心行健康体检的身体健康者94例作为对照组。分析LEDVT患者超声特征;分析2组一般资料,采用多因素Logistic回归分析,寻找LEDVT的危险因素。结果观察组二维灰阶超声检查示:静脉管径变大、张力增强,管腔出现不同程度阻塞,血栓处管腔扩张呈低回声信号;彩色多普勒血流显像(CDFI)示血栓处管腔内无血流信号或信号微弱;脉冲多普勒(PW)示静脉无相性变化或相性减弱。年龄>40岁、手术/外伤史、肿瘤史、3年以上肢体活动受限史、静脉淤滞指数(SI)升高、血流最大速度(V max)降低及股总静脉内径(D)增加是LEDVT的独立危险因素(P<0.05或P<0.01)。结论LEDVT超声特征性征象为静脉管径变大、张力增强,管腔不同程度阻塞,血栓处管腔扩张呈低回声信号,CDFI示血栓处管腔无血流信号或信号微弱,PW示静脉无相性变化或相性减弱。年龄>40岁、手术/外伤史、肿瘤史、3年以上肢体活动受限史、SI升高、V max降低及D增加是LEDVT的独立危险因素,对具有以上危险因素者应提前干预,以改善预后。

Objective To investigate the ultrasonic characteristics and risk factors of lower extremity deep venous thrombosis(LEDVT).Methods A total of 156 patients with LEDVT diagnosed by color Doppler ultrasound in our hospital from January 2019 to December 2019 were selected as the observation group,and 94 healthy people who underwent physical examination in physical examination center of our hospital during the same period were selected as the control group.The ultrasonic characteristics of LEDVT patients and the general data of the two groups were analyzed.Multivariate logistic regression analysis was used to explore the risk factors of LEDVT.Results The two-dimensional gray-scale ultrasound examination in the observation group showed larger diameter of the vein,increased tension increased,blocked lumen to different degrees;the lumen dilation at the thrombus showed low echo signal.Color Doppler flow imaging(CDFI)showed no blood flow signal or weak signal in the lumen at the thrombus;pulse wave Doppler(PW)showed no phase change or phase weakening of the vein.The independent risk factors of LEDVT included age>40 years,history of surgery/trauma,history of tumor,history of limb movement restriction for more than 3 years,increased venous stasis index(SI),decreased maximum velocity(V max)and increased diameter of common femoral vein(D)(P<0.05 or P<0.01).Conclusion The characteristic ultrasonic signs of LEDVT are enlargement of vein diameter,enhancement of tension,obstruction of lumen in different degrees,dilation of lumen at thrombus and low echo signal.CDFI shows no blood flow signal or weak signal in lumen at thrombus,and PW shows no phase change or phase weakening of vein.The independent risk factors of LEDVT were age>40 years,history of surgery/trauma,history of tumor,history of limb movement restriction for more than 3 years,increased SI,decreased V max and increased D.Intervention should be performed on the patients with the above risk factors in advance to improve the prognosis.