摘要
目的探讨彩色多普勒超声在老年骨折患者下肢深静脉血栓诊断中的价值。方法选取医院2016年6月—2020年6月收治的老年骨折后疑似下肢深静脉血栓患者56例(69条),所有患者均采用PHILIPS HD11XE彩色多普勒超声诊断仪进行扫描检查,设定探头频率3.5 MHz以及5~12 MHz。患者仰卧位下肢舒展,由两侧对照检查,从近到远检查股静脉、髂静脉,更换俯卧位检查胫后静脉、腘静脉,下肢的深静脉使用横轴与纵轴的扫描检查。以下肢静脉造影片子所示深静脉血栓大小及部位结果为"金标准",观察彩色多普勒超声在老年骨折患者下肢深静脉血栓中检出率、血栓部位、回声情况及彩色血流充盈情况。结果经下肢静脉造影确诊56例(62条)患者均为下肢深静脉血栓,彩色多普勒超声检查后检出老年骨折后下肢深静脉血栓患者51例(57条),检出率91.07%,左下肢血栓患者32例(36条),右下肢血栓患者19例(21条),股静脉血栓患者例数最多。急性期血栓26例(29条),亚急性期血栓21例(24条)。急性期血栓表现为低回声,患者血管管腔加压不能压扁,亚急性血栓呈强回声、等回声,患者血管直径粗细不一,管壁变厚增粗,回声显著增强。急性及亚急性期血栓多普勒彩色超声均显示为血栓处彩色血流信号缺损。结论在老年骨折患者下肢深静脉血栓诊断中应用彩色多普勒超声可准确诊断患者血栓部位,得出患者血栓回声情况及彩色血流充盈情况,可及时诊断,为患者治疗提供依据。
Objective To explore the value of color Doppler ultrasound in the diagnosis of deep venous thrombosis of lower limbs in elderly patients with fracture.Methods From June 2016 to June 2020,56 elderly patients(69 cases)with suspected deep venous thrombosis of lower limbs after fracture were selected and examined by venography.All patients were scanned with PHILIPS HD11 XE color Doppler ultrasound diagnostic instrument.Set the probe frequency of 3.5 MHz and 5 to 12 MHz.Patients in supine position with lower limb extension were examined by two sides.The femoral vein and iliac vein were examined from proximal to distal.The posterior tibial vein and popliteal vein were examined in prone position.The deep veins of the lower limbs were examined by axial and axial scanning.The size and location of deep vein thrombosis shown in lower limb venography was considered as the"gold standard".To observe the detection rate,thrombus location,echo and color flow filling of deep venous thrombosis in the lower limbs of elderly fracture patients by color Doppler ultrasound.Results 56 patients(62 pieces)were diagnosed as DVT by lower extremity venography.After color Doppler ultrasound examination,51 elderly patients(57 pieces)with deep venous thrombosis of lower limbs after fracture were detected,and the detection rate was 91.07%.There were 32 patients(36 pieces)with thrombus in left lower extremity,19 patients(21 pieces)with thrombus in right lower extremity,and the number of patients with thrombus in femoral vein was the largest.There were 26 patients(29 thrombus)in acute phase,21 patients(24 thrombus)in subacute phase.In the acute stage,thrombus manifests as hypoechoic,blood vessel lumen pressure can not be compressed,subacute thrombus showed strong echo,isoechoic,the diameter of blood vessel was different,the wall becomes thicker and thicker,and the echo was significantly enhanced.Color Doppler ultrasonography of thrombus in acute and subacute stages showed color flow signal defect at thrombus site.Conclusion The application of color Doppler ultrasound in the diagnosis of deep venous thrombosis in the lower limbs of elderly patients with fracture can accurately diagnose the location of the thrombus,and obtain the echo condition of the thrombus and the filling condition of the color flow,which can provide the basis for the timely diagnosis and treatment of the patients.
作者
何昀枚
HE Yunmei(Department of Ultrasonography,Jintan Hospital of Traditional Chinese Medicine,Changzhou Jiangsu 213200,China)
出处
《中国卫生标准管理》
2021年第11期50-52,共3页
China Health Standard Management
关键词
下肢
深静脉血栓
老年
骨折
彩色多普勒超声
造影
lower limb
deep venous thrombosis
elderly
fracture
color Doppler ultrasound
radiography
