彩色多普勒超声在骨折术后患者下肢深静脉血栓形成中的诊断价值及相关参数分析

Diagnostic value of color Doppler ultrasonography in patients with lower extremity deep vein thrombosis after fracture operation and analysis of related parameters

目的:分析彩色多普勒超声在骨折术后患者下肢深静脉血栓(LEDVT)形成中的诊断价值及相关参数。方法:回顾性选取2021年3月—2023年3月于临沭县中医医院与千佛山医院治疗的96例疑为骨折术后LEDVT患者。所有患者均行彩色多普勒超声及下肢静脉造影检查。以下肢静脉造影检查结果作为“金标准”,计算彩色多普勒超声诊断灵敏度、特异度、准确率及彩色多普勒超声诊断结果与病理结果的一致性,并依据是否发生LEDVT分为发生LEDVT组与未发生LEDVT组,比较两组股总静脉(CFV)、股浅静脉(SFV)、股深静脉(DFV)内径。结果:经下肢静脉造影检查证实96例疑为骨折术后LEDVT患者中LEDVT发生55例,未发生41例;彩色多普勒超声诊断阳性53例、阴性43例,其中误诊、漏诊分别为3例、5例,彩色多普勒超声诊断灵敏度90.91%、特异度92.68%、准确率为91.67%;彩色多普勒超声诊断结果与下肢造影检查结果一致性极好(Kappa=0.834);发生LEDVT患者的CFV、SFV及DFV内径均大于未发生LEDVT患者,差异有统计学意义(P<0.05)。结论:彩色多普勒超声用于骨折术后患者LEDVT形成的诊断效能较高,诊断LEDVT结果与下肢造影检查结果一致性极好,通过分析彩色多普勒超声相关参数能够为LEDVT的诊治提供参考。

Objective To analyze the diagnostic value and related parameters of color Doppler ultrasound(CDS)in the formation of lower extremity deep venous thrombosis(LEDVT)after fracture surgery.Methods A total of 96 patients suspected of LEDVT after fracture were selected from Linshu Hospital of Traditional Chinese Medicine and Qianfo Mountain Hospital from March 2021 to March 2023.All patients underwent CDS and lower extremity venography.The lower extremity venography results were taken as the"gold standard"to calculate the sensitivity,specificity and accuracy of CDS diagnosis and the consistency of CDS diagnosis results with lower extremity venography results.According to whether LEDVT occurred,the patients were divided into LEDVT group and no LEDVT group.The diameter of common femoral vein(CFV),superficial femoral vein(SFV)and deep femoral vein(DFV)were compared between the two groups.Results LEDVT was found in 55 of the 96 patients suspected to be LEDVT after fracture and 41 without LEDVT.There were 53 positive cases and 43 negative cases,including 3 misdiagnosis cases and 5 missed cases,respectively.The sensitivity,specificity and accuracy of color Doppler ultrasound diagnosis were 90.91%,92.68%and 91.67%.The results of color Doppler ultrasonography were in good agreement with those of lower extremity venography(Kappa=0.834).The inner diameters of CFV,SFV and DFV in patients with LEDVT were higher than those in patients without LEDVT,and the difference was statistically significant(P<0.05).Conclusion CDS has a high diagnostic efficiency for the formation of LEDVT in patients after fracture surgery.The consistency between CDS diagnosis of LEDVT and lower limb imaging results is excellent.Analyzing CDS related parameters can provide reference for the diagnosis and treatment of LEDVT.