摘要
目的探究彩色多普勒超声联合血浆D-二聚体检测在长期卧床患者下肢深静脉血栓（DVT）诊断中的应用价值。方法选择246例疑似DVT的长期卧床患者，对其采取彩色多普勒超声检查及血浆D-二聚体水平测定。以静脉造影结果作为＂金标准＂，分析彩色多普勒超声、血浆D-二聚体单独及联合诊断DVT的特异度、敏感度、准确度，并对比不同类型（混合型、中央型、周围型）DVT患者的血浆D-二聚体水平。结果静脉造影检查显示，本组246例疑似DVT的长期卧床患者中证实为DVT者68例，非DVT者178例；血浆D-二聚体诊断出DVT 79例，非DVT 167例；彩色多普勒超声诊断出DVT 76例，非DVT 170例；彩色多普勒超声与血浆D-二聚体联合诊断出DVT 95例，非DVT 151例。采用彩色多普勒超声联合血浆D-二聚体诊断DVT的敏感度为97.06%（66/68），高于彩色多普勒超声、血浆D-二聚体单一检测；准确度为87.40%（215/246），高于血浆D-二聚体、彩色多普勒超声单一检测，差异有统计学意义（P〈0.05）；联合诊断与单一方法诊断的特异度比较，差异未见统计学意义（P〉0.05）；单因素分析可知，不同类型DVT患者的血浆D-二聚体水平比较，差异有统计学意义（P〈0.05），且混合型DVT患者血浆D-二聚体水平高于中央型，中央型高于周围型，差异有统计学意义（P〈0.05）。结论彩色多普勒超声联合血浆D-二聚体检测可明显提升长期卧床患者DVT诊断的敏感度、准确度，降低漏诊风险，且能为疾病分型提供一定依据。
Objective To investigate the application value of the color Doppler ultrasound com- bined plasma D-dimer test in the diagnosis of deep vein thrombosis of lower extremity （DVT） in long- term bedridden patients. Methods A total of 246 long-term bedridden patients with suspected DVT were selected and examined by color Doppler ultrasonography and plasma D-dimer test. The results of the venous angiography were considered as the ＂gold standard＂. The specificity, sensitivity and accuracy of the color Doppler ultrasound and plasma D-dimer test for diagnosis of DVT were analyzed. And the levels of plasma D-dimer were compared among the patients with DVT. Results Intravenous angiography showed that of the 246 long-term bedridden patients with suspected DVT, 68 cases were confirmed as DVT patients and 178 cases were confirmed as non DVT patients. Seventy-nine patients were diagnosed as DVT and 167 patients were diagnosed as non DVT by plasma D-dimer test. Color Doppler ultrasound found 76 cases of DVT and 170 cases of non DVT. The sensitivity of color Doppler ultrasound combined with plasma D-dimer for diagnosis of DVT was 97.06% （66/68）, which was higher than that of color Doppler ultrasound single test and plasma D-dimer, and the accuracy was 87.40% （215/246 ） , which was higher than that of plasma D-dimer and color Doppler ultrasound. The differences were statistically significant （ P 〈 0. 05 ）. There was no significant difference in the specificity and the specificity between the combined method and the two single methods （ P 〉 0. 05 ）. Univariate analysis showed that the differ- ences in the level of plasma D-dimer in different types of DVT patients were statistically significant （ P 〈0. 05 ）. The level of plasma D-dimer in patients with mixed DVT was higher than that of central type, and the plasma D-dimer level of central type was higher than that of peripheral type, and the difference was statistically significant （P 〈 0. 05 ）. Conclusions Color Doppler ultrasound combined with plasma D-dimer test can significantly improve the sensitivity and accuracy for DVT diagnosis in long-term bedrid- den patients, reduce the risk of missed diagnosis, and provide a basis for disease classification.
作者
王丽丽
Wang Lili(Department of Ultrasonography, the Third Hospital of Traditional Chinese Medicine of Shanxi University of Traditional Chinese Medicine, Taiyuan 030012, China)
出处
《中国实用医刊》
2018年第7期60-63,共4页
Chinese Journal of Practical Medicine
关键词
长期卧床患者
下肢深静脉血栓
彩色多普勒超声
D-二聚体
敏感度
准确度
Long-term bedridden patients
Deep venous thrombosis of lower extremity
ColorDoppler ultrasound
D-dimer
Sensitivity
Accuracy
