超声检查在妊娠期或产褥期下肢深静脉血栓诊断中的应用价值

Application value of ultrasound in diagnosis of lower extremity deep vein thrombosis during pregnancy or puerperium

目的 探讨超声检查在妊娠期或产褥期下肢深静脉血栓诊断中的应用价值。方法 收集2017年1月至2022年9月于中山市小榄人民医院接受下肢深静脉超声检查的343例妊娠期或产褥期女性,根据是否检查出下肢深静脉血栓分为血栓组(n=31)和对照组(n=312)。比较两组患者的一般资料,记录内侧腓肠静脉、腘静脉、股浅静脉、股静脉内径,比较两组患者下肢深静脉血栓的超声表现。结果 血栓组患者年龄、孕次、产次、D-二聚体水平、收缩压均高于对照组患者,差异均有统计学意义(P﹤0.05)。血栓组患者内侧腓肠静脉、腘静脉、股浅静脉、股静脉内径均明显大于对照组患者,差异均有统计学意义(P﹤0.05)。血栓组患者下肢深静脉血栓以单侧肢体受累为主,其中,左下肢17例,右下肢12例,双下肢2例;彩色多普勒超声可见血流信号消失、充盈缺损,不完全闭塞11例,完全闭塞20例;周围型11例,中央型16例,混合型4例。结论 超声检查对妊娠期或产褥期女性的下肢深静脉血栓有较好的诊断价值,可结合患者的临床症状、体征以及血清D-二聚体水平进一步予以筛查。

Objective To explore the application value of ultrasound in the diagnosis of lower extremity deep vein thrombosis during pregnancy or puerperium.Method A total of 343 pregnancy and puerperium women who received ultrasonic examination of lower extremity deep vein from January 2017 to September 2022 in the Xiaolan People's Hospital of Zhongshan were selected.According to whether the lower extremity deep vein thrombosis was detected,they were divided into thrombosis group(n=31)and control group(n=312).The baseline data of the two groups were compared,the inside diameters of medial sural vein,popliteal vein,superficial femoral vein and femoral vein were recorded,the ultrasonic manifestations of lower extremity deep vein thrombosis were compared.Result The age,gestational orders,parity,D-dimer level,systolic blood pressure of patients in the thrombosis group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The inside diameters of medial sural vein,popliteal vein,superficial femoral vein and femoral vein in the thrombosis group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).The unilateral extremity were mainly involved for lower extremity deep vein thrombosis in thrombosis group,in which,there were 17 cases of left lower extremities,12 cases of right lower extremities and 2 cases of bilateral lower extremities.Color Doppler ultrasound can show the disappearance of blood flow signal and filling defect,with 11 cases of incomplete occlusion and 20 cases of complete occlusion.Among 37 cases of lower limb deep vein thrombosis,11 cases were peripheral type,16 cases were central type,and 4 cases were mixed type.Conclusion In pregnancy or puerperaium women,ultrasound examination has diagnosis value in detection of lower extremity deep vein thrombosis,it can be performed based on clinical symptoms,vital signs and serum D-dimer.