摘要
目的探讨超声造影定量分析技术对髋关节置换术后下肢深静脉血栓形成的诊断价值。方法回顾性选取2021年6月至2022年6月于青岛市胶州中心医院进行髋关节置换术后怀疑下肢深静脉血栓的150例患者,均采用彩色多普勒超声诊断仪对患者下肢深静脉血管进行检查,并行超声造影定量分析,记录患者彩色多普勒超声检测结果,比较下肢深静脉血栓患者及正常患者超声造影定量参数[达峰时间(TIP)、峰值强度(DPI)、曲线上升支斜率(C)]的差异,并比较下肢深静脉血栓患者急性期、亚急性期和慢性期血栓弹性评分、血栓应变比值的差异。结果血管造影结果显示82例患者诊断为下肢深静脉血栓,超声造影与血管造影在诊断下肢深静脉血栓方面的Kappa值为0.904,灵敏度为95.00%,特异度为91.43%,准确率为93.33%,阳性预测值为92.68%,阴性预测值为94.12%。超声检查与血管造影在诊断下肢深静脉血栓的Kappa值为0.616,灵敏度为77.55%,特异度为88.46%,准确率为81.33%,阳性预测值为92.68%,阴性预测值为67.65%。下肢深静脉血栓组TIP水平高于正常组,DPI、C水平低于正常组[(40.21±12.34)s比(13.50±4.59)s、(-32.27±7.56)dB比(-11.33±3.07)dB、(1.88±0.40)dB/s比(4.75±1.34)dB/s],差异有统计学意义(P<0.05)。在下肢深静脉血栓患者中,急性期血栓28例,亚急性期血栓22例,慢性期血栓32例,不同时期下肢深静脉血栓患者血栓弹性评分、血栓应变比值比较差异有统计学意义(P<0.05),急性期血栓患者血栓弹性评分、血栓应变比值最低。结论超声造影定量分析技术在髋关节置换术后下肢深静脉血栓诊断中与血管造影具有良好的一致性,且对于分期诊断也具有一定的临床意义。
Objective To explore the diagnostic value of quantitative analysis of contrast-enhanced ultrasound for deep venous thrombosis of lower extremity after total hip arthroplasty.Methods A total of 150 patients suspected of deep venous thrombosis of lower extremity undergoing total hip arthroplasty treatment in Jiaozhou Central Hospital of Qingdao from June 2021 to June 2022 were selected.Color Doppler ultrasound diagnostic instrument was used to examine the deep vein vessels of the lower limbs of patients,and quantitative analysis of contrast-enhanced ultrasound was performed to record the color Doppler detection results of patients.Quantitative parameters of contrast-enhanced ultrasound including time to peak(TIP),derived peak intensity(DPI),slope of ascending branch of curve(C)were compared between patients with deep vein thrombosis of lower extremities and normal patients.According to the onset time of symptoms of lower extremity thrombus group,patients were divided into acute stage,subacute stage and chronic stage,and the thrombus elasticity score and thrombus strain ratio among the three subgroups were compared.Results Angiography results showed that 82 patients were diagnosed with deep vein thrombosis of lower extremities.The Kappa=0.904,sensitivity was 95.00%,specificity was 91.43%,accuracy was 93.33%,positive prediction rate was 92.68%,and negative prediction rate was 94.12%by using contrast-enhanced ultrasonography and angiography in the diagnosis of deep vein thrombosis of lower extremity.The Kappa=0.616,the sensitivity was 77.55%,specificity was 88.46%,accuracy was 81.33%,positive prediction rate was 92.68%,negative prediction rate was 67.65%by using ultrasonography and angiography in the diagnosis of deep venous thrombosis of lower extremities.The TIP level in patients with deep venous thrombosis of lower limbs was higher than that in normal patients,the DPI and C levels were lower than that in normal patients:(40.21±12.34)s vs.(13.50±4.59)s,(-32.27±7.56)dB vs.(-11.33±3.07)dB,(1.88±0.40)dB/s vs.(4.75±1.34)dB/s,there were statistical differences(P<0.05).There were 28 cases of acute stage thrombosis,22 cases of subacute stage thrombosis,and 32 cases of chronic stage thrombosis.There were statistically significant differences in thrombus elasticity score and thrombus strain ratio among patients with lower extremity thrombosis at different periods.Thrombus elasticity score and thrombus strain ratio of patients with acute stage thrombus were the lowest.Conclusions Quantitative analysis of contrast-enhanced ultrasound has good consistency in the diagnosis of lower extremity deep vein thrombosis after total hip arthroplasty,and has certain clinical significance for staging diagnosis of lower extremity deep vein thrombosis.
作者
宋爱华
田祥燕
高美华
郑兆霞
Song Aihua;Tian Xiangyan;Gao Meihua;Zheng Zhaoxia(Operation Room,Qingdao Jiaozhou Central Hospital,Qingdao 266300,China;Department of Hemodialysis,Qingdao Jiaozhou Central Hospital,Qingdao 266300,China;Department of Outpatient,Qingdao Jiaozhou Central Hospital,Qingdao 266300,China)
出处
《中国医师进修杂志》
2024年第6期561-565,共5页
Chinese Journal of Postgraduates of Medicine
关键词
超声检查
造影剂
关节成形术
置换
髋
下肢深静脉血栓
诊断
Ultrasonography
Contrast media
Arthroplasty,replacement,hip
Lower extremity deep vein thrombosis
Diagnosis
作者简介
通信作者:郑兆霞,Email:zhengzx0532@126.com。
