血管超声对下肢骨折患者术前下肢深静脉血栓的诊断价值研究

Diagnostic Value of Vascular Ultrasound for Preoperative Deep Venous Thrombosis in Patients With lower Limb Fractures

目的探究血管超声对下肢骨折患者下肢深静脉血栓(DVT)的诊断价值。方法选择325例单侧下肢骨折患者作为研究对象,所有患者术前行血管超声检查及CT造影检查,比较两种检查方式对DVT的检出情况。结果超声共检出DVT患者68例,检出78支静脉血栓;CT静脉造影检查检出血栓形成患者69例,检出81支静脉血栓。共78支血管经两种方式检查完全一致,分别有1支髂静脉、胫后静脉、胫前静脉血栓未被超声检出。以CT静脉造影结果作为标准,超声诊断深静脉血栓的敏感度为96.29%,漏诊率为3.71%;超声及CT静脉造影对完全梗阻、不完全梗阻、机化后再通、侧支循环建立等类型检出率比较无统计学意义(P>0.05)。结论超声在诊断下肢骨折患者深静脉血栓方面具有与CT静脉造影相当的诊断效能,可为临床诊断有较高的参考价值。

Objective To investigate the diagnostic value of vascular ultrasound for deep venous thrombosis(DVT)in patients with lower limb fractures.Methods A total of 325 patients with unilateral lower limb fractures who were treated in the hospital were selected as the subjects.All subjects underwent vascular ultrasonography and CT angiography before surgery.The detection of DVT by the two methods was compared.Results A total of 68 patients having 78 veins with thrombosis were detected by ultrasound,and 69 patients having 81 veins with thrombosis were detected by CT venography.A total of 78 blood vessels detected by the two methods were completely consistent.There was 1 iliac vein,1 posterior tibial vein,and 1 anterior tibial vein thrombosis not detected by ultrasound.Taking the results of CT venography as the standard,the sensitivity and misdiagnosis rate of ultrasound for DVT were 96.29% and 3.71%,respectively.There was no statistically significant difference in the detection rate of complete obstruction,incomplete obstruction,recanalization after organization or establishment of collateral circulation between ultrasound and CT venography(P>0.05).Conclusion The diagnostic efficiency of ultrasound is comparable to that of CT venography in the diagnosis of DVT in patients with lower limb fractures,and it can provide a reference for clinical diagnosis.