彩色多普勒超声对中高危孕产妇下肢深静脉血栓的评估价值

Value of color Doppler ultrasound in the evaluating of lower extremity deep vein thrombosis in medium-high risk pregnant and parturient women

目的探讨基于Caprini评分的彩色多普勒超声对中高危孕产妇发生下肢深静脉血栓(DVT)的筛查价值。方法收集2020年1月至2021年12月于沧州市妇幼保健院接受诊治的150例中高危孕产妇的临床资料,分为中危组(n=97)和高危组(n=53)。收集孕产妇的临床基本信息,包括年龄、基础病史、孕产史、Caprini评分、彩色多谱勒超声检查结果,总结、分析其下肢DVT发生情况和超声图像特点。结果高危组孕产妇的年龄、体重指数、D-二聚体水平均明显高于中危组孕产妇,差异均有统计学意义(P﹤0.05)。43例孕产妇发生下肢DVT,其中,高危组孕产妇下肢DVT的发生率为43.4%(23/53),高于中危组孕产妇的20.6%(20/97),差异有统计学意义(P﹤0.05)。未检出下肢DVT的107例孕产妇中,未发现明显异常51例;血流缓慢56例,其中,23例孕产妇在出院随访中发生下肢DVT,中危组孕产妇在出院随访过程中下肢DVT的发生率为31.6%(12/38),低于高危组的61.1%(11/18),差异有统计学意义(P﹤0.05)。43例发生下肢DVT的孕产妇中,血流完全中断19例,血流变细24例,血栓图像呈现团块状和条索状实性回声。结论基于Caprini评分的彩色多普勒超声检查可以方便、准确、安全评估中高危孕产妇的下肢DVT发生情况。

Objective To investigate the screening value of color Doppler ultrasound in the evaluation of lower extremity deep vein thrombosis(DVT)in medium-high risk pregnant and parturient women by Caprini scoring.Method Clinical data of 150 medium-high risk pregnant and parturient women treated in Cangzhou Maternal and Child Health Hospital from January 2020 to December 2021 were collected,and all patients were divided into the medium risk group(n=97)and high risk group(n=53).Basic clinical information of pregnant and postpartum women were collected,including age,basic medical history,pregnancy and childbirth history,Caprini score results,color Doppler ultrasound examination results,lower extremity of DVT and ultrasound image characteristics were summarized and analyzed.Result The age,body mass index and D-dimer level of pregnant and parturient women in high-risk group were significantly higher than those in medium risk group,and the differences were statistically significant(P<0.05).A total of 43 pregnant and parturient women developed lower extremity DVT,among which the incidence of lower extremity DVT in the high-risk group was 43.4%(23/53),which was higher than the 20.6%(20/97)in the medium risk group,and the differences were statistically significant(P<0.05).Among the 107 pregnant and postpartum women who did not detect lower extremity DVT,no significant abnormalities were found in 51 cases;56 cases of slow blood flow,of which 23 cases developed lower extremity DVT during discharge follow-up,among them,the incidence rate of lower extremity DVT in the medium risk group during follow-up was 31.6%(12/38),which was lower than 61.1%(11/18)in the high-risk group,and the difference was statistically significant(P<0.05).Among the 43 cases patients of lower extremity DVT,19 cases patients had complete interruption of blood flow and 24 cases patients had fine hemorheology.The thrombus image presented solid echogenicity in the form of clumps and stripes.Conclusion Color Doppler ultrasound based on Caprini scoring can conveniently,accurately and safely assess the condition of lower extremity DVT in high-risk pregnant and parturient women.