| 摘要: |
| 目的 常规超声通过测量静脉内径和流速来评估下肢深静脉血栓（DVT）发生前静脉变化，受干扰因素较多，现应用股总静脉（CFV）、股浅静脉（SFV）、腘静脉（POV）管腔横截周长2/横截面积（C2/A）量化评估血栓发生前静脉变化，初步探讨C2/A评估血栓发生前静脉变化的价值。 方法 选择骨科无血栓住院患者150例，术前超声测量CFV、SFV、POV的横截周长值(C) 、横截面积值（A）及C2/A比值、静脉流速及内径值，术后超声监测血栓发生情况，评估新参数C2/A评估血栓发生前的价值。 结果 150例患者术后7天内发生血栓37例（24.70%），未发生血栓113例（75.30%）。与非血栓组比较，血栓组CFV内径, CFV-C, CFV-A, CFV-C2/A, SFV-C, SFV-C2/A, POV-C, POV-A和POV-C2/A均显著增加（P均＜0.05）。ROC分析显示，当CFV-C2/A，SFV-C2/A，POV-C2/A分别以＞17.4, 17.1, 17.0为截点值，曲线下面积分别为0.939 (95%CI: 0.888 -0.972,P＜0.001), 0.937(95%CI: 0.886-0.970,P＜0.001)和0.917(95%CI: 0.861-0.956, P＜0.001)。预测血栓的敏感度分别为91.7%, 94.6%和91.9%,特异度分别为97.4%, 95.6%和93.8%。结论 超声参数C2/A比值有较高的预测血栓价值，受干扰因素相对较少，可为临床早期干预血栓发生提供新的思路。 |
| 关键词: 超声成像 下肢深静脉 血栓前状态 预防 |
| DOI： |
| 投稿时间：2022-12-13修订日期：2023-01-02 |
| 基金项目:国家自然科学基金面上项目(82071932) |
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| Evaluation the value of early venous changes of lower extremity before deep vein thrombosis by ultrasonic parameters in orthopedic patients |
| CHEN Xi,AN Li,GU Fen,TIAN Feng,LIU Liwen |
| () |
| Abstract: |
| Objective Conventional ultrasonic measuring diameter and velocity of the vein to evaluate early venous tension changes of lower extremity deep vein thrombosis (DVT) with poor accuracy and repeatability. By applying the ratio cross-sectional perimeter2/cross-sectional area (C2/A) of common femoral vein(CFV), superficial femoral vein (SFV) and popliteal vein (POV) to evaluate DVT early vein tension change, discuss cut-off value method and diagnostic value of the C2/A preliminarily. Methods 150 patients in orthopedic without DVT underwent duplex ultrasound scan were studied. The value of venous flow velocity, Internal diameter, cross-sectional area(A), cross-sectional perimeter (C) and the ratio of C2/A of CFV, SFV and POV were recorded. The incidence of DVT were monitored by ultrasound after surgery and compared the value of the new parameter of C2/A before DVT occured. P<0.05 was considered statistically significant. Results There were significant differences in CFV inner diameter, CFV-C, CFV-A, CFV-C2/A, SFV-C, SFV-C2/A, POV-C, POV-A and POV-C2/A between the DVT group (24.70%) and the non-DVT group (75.30%) (all P<0.05). Area under curve (AUC) for CFV-C2/A, SFV-C2/A, and POV-C2/A as followed: 0.939 (95%CI: 0.888 -0.972, P<0.001), 0.937 (95%CI: 0.886 -0.970, P<0.001), and 0.917 (95%CI: 0.861-0.956, P<0.001), respectively; sensitivity 91.7%, 94.6%, and 91.9% , respectively; specificity 97.4%, 95.6%, and 93.8%, respectively. Conclusion The ratio of C2/A has high value in predicting thrombosis, and the interference factors are relatively less. It is providing new thinking and reference for intervention for clinical preventing DVT early. |
| Key words: Ultrasonic parameter Deep veins of the lower extremities Prethrombotic state Prevention |
