下肢静脉加压超声联合心脏彩超对肺血栓栓塞症的诊断价值

Diagnostic value of lower extremity venous compression ultrasound and cardiac color Doppler ultrasound for pulmonary thromboembolism

目的探讨下肢静脉加压超声联合心脏彩超对肺血栓栓塞症(PTE)的诊断价值。方法选取2020年1月至2021年4月在空军军医大学唐都医院治疗的112例疑似PTE患者作为研究对象,以中华医学会呼吸病学分会公布的肺血栓栓塞症诊治与预防指南作为金标准,将50例确诊PTE患者作为阳性组,62例非PTE患者作为阴性组。比较两组患者下肢静脉加压超声和心脏彩超检查结果,分析下肢静脉加压超声、心脏彩超单独及联合对PTE的诊断价值。结果阳性组患者的下肢静脉加压超声、心脏彩超阳性率分别为80.00%、78.00%,明显高于阴性组的14.52%、29.03%,差异均有统计学意义(P<0.05);下肢静脉加压超声联合心脏彩超检查的准确率、灵敏度、特异度、阴性似然值、阳性似然值分别为96.43%、96.00%、96.77%、96.77%、96.00%,明显高于下肢静脉加压超声的83.04%、80.00%、85.48%、84.13%、81.63%及心脏彩超的74.11%、78.00%、70.97%、80.00%、68.42%,差异均有统计学意义(P<0.05)。结论下肢静脉加压超声联合心脏彩超诊断PTE相较于二者单独检查,诊断价值较高,值得推广应用。

Objective To investigate the diagnostic value of lower extremity venous compression ultrasound combined with cardiac color Doppler ultrasound in pulmonary thromboembolism(PTE).Methods A total of 112 patients with suspected PTE who were treated in Tangdu Hospital of Air Force Medical University from January 2020 to April 2021 were selected as the research subjects.The guidelines for the diagnosis,treatment and prevention of pulmonary thromboembolism published by Respiratory Medicine Branch,Chinese Medical Association,were used as the gold standard.Fifty patients confirmed as PTE were selected as the positive group,and 62 patients not confirmed as PTE were selected as the negative group.The results of lower extremity venous compression ultrasound and cardiac color Doppler ultrasound were compared between the two groups,and the diagnostic value of lower extremity venous compression ultrasound and cardiac color Doppler ultrasound alone and in combination was analyzed.Results The positive rates of lower extremity venous compression ultrasound and cardiac color Doppler ultrasound were 80.00% and 78.00% in the positive group,which were significantly higher than 14.52% and 29.03% of the negative group(P<0.05).The accuracy,sensitivity,specificity,negative likelihood,and positive likelihood of lower extremity venous compression ultrasound combined with cardiac color Doppler ultrasound were 96.43%,96.00%,96.77%,96.77%,and 96.00%,which were significantly higher than 83.04%,80.00%,85.48%,84.13%,81.63%of lower extremity venous compression ultrasound and 74.11%,78.00%,70.97%,80.00%,68.42%of cardiac color Doppler ultrasound(P<0.05).Conclusion Compared with single examination,lower extremity venous compression ultrasound combined with cardiac color Doppler ultrasound in the diagnosis of PTE has higher diagnostic value,which is worthy of popularization and application.