彩色多普勒检查对原发性下肢深静脉瓣功能不全的诊断价值
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摘要
目的应用彩色多普勒超声检查技术诊断原发性下肢深静脉功能不全。方法方便选取2017年1月—2018年1月在该院就诊病例112例,选取临床上表现下肢肿胀、色素沉着、溃疡等症状的患者为病例组,76例患者表现原发性下肢深静脉瓣功能不全排除继发性原因的48条下肢深静脉作为病例组,正常人群36例62条下肢深静脉作为对照组。应用彩超测量并对比血管内径、平均血流速度、血液返流时间和最大返流速度。结果病例组的四组数据(血管内径、平均血流速度、血液返流时间和最大返流速度):股总静脉(7.61±0.85)mm、(6.42±0.84)cm/s、(722±339)ms、(13.00±0.92)cm/s、股浅静脉(7.02±0.42)mm、(5.22±0.93)cm/s、(521±279)ms、(11.67±6.07)cm/s、腘静脉(9.38±0.69)mm、(6.70±1.10)cm/s、(590±334)ms、(9.65±2.59)cm/s。对照组的数据:股总静脉(5.96±0.76)mm、(10.50±2.31)cm/s、(58±119)ms、(1.29±2.47)cm/s、股浅静脉(4.03±1.14)mm、(8.71±1.59)cm/s、(25.80±76.31)ms、(0.53±1.53)cm/s、腘静脉(6.55±1.41)mm、(9.67±3.49)cm/s、(22.92±65.11)ms、(0.50±1.37)cm/s。血管内径比较差异有统计学意义:股总静脉(t=7.49,P=0.021),股浅静脉(t=8.12,P=0.017),腘静脉(t=4.81,P=0.023);平均血流速度比较差异有统计学意义:股总静脉(t=8.23,P=0.007),股浅静脉(t=6.67,P=0.018),腘静脉(t=2.06,P=0.033);血液返流时间比较差异有统计学意义:股总静脉(t=10.12,P=0.000),股浅静脉(t=10.54,P=0.000),腘静脉(t=10.86,P=0.001);最大返流速度比较差异有统计学意义:(股总静脉t=8.74,P=0.000),股浅静脉(t=11.12,P=0.000),腘静脉(t=8.52,P=0.000)。结论彩色多普勒超声检查技术在诊断原发性下肢深静脉功能不全中准确率高,可作为首选检查手段。
Objective To investigate the diagnosis of primary deep venous insufficiency of lower extremity by color Doppler ultrasonography. Methods From January 2017 to January 2018, 112 case patients in our hospital were selected. The patients with symptoms of lower extremity swelling, pigmentation and ulcer were convenient selected as the case group. 76 patients showed primary deep venous valve of lower extremity. Incomplete function excludes 48 deep veins of the lower extremity as a case group, and 36 cases of 62 deep veins of the lower extremity in the normal population as a control group.Color Doppler ultrasound was used to measure and compare vessel inner diameter, mean blood flow velocity, blood reflux time, and maximum reflux velocity. Results Four groups of data(vascular diameter, mean blood flow velocity, blood reflux time and maximum reflux velocity): total femoral vein(7.61±0.85)mm,(6.42±0.84)cm/s,(722±339)ms,(13.00±0.92)cm/s, super ficial femoral vein(7.02±0.42)mm,(5.22±0.93)cm/s,(521±279)ms,(11.67±6.07)cm/s, iliac vein(9.38±0.69)mm,(6.70±1.10)cm/s,(590±334)ms,(9.65±2.59)cm/s. Data from the control group: total femoral vein(5.96±0.76)mm,(10.50±2.31)cm/s,(58±119)ms,(1.29±2.47)cm/s, superficial femoral vein(4.03 ±1.14)mm,(8.71±1.59)cm/s,(25.80 ±76.31)ms,(0.53±1.53)cm/s, iliac vein(6.55±1.41)mm,(9.67±3.49)cm/s,(22.92±65.11)ms,(0.50±1.37)cm/s. The difference in blood vessel diameter was statistically significant: total femoral vein(t=7.49, P=0.021), superficial femoral vein(t=8.12, P=0.017), iliac vein(t=4.81,P=0.023);mean blood flow had difference in speed was statistically significant: total femoral vein(t =8.23, P =0.007), superficial femoral vein(t=6.67, P=0.018), iliac vein(t=2.06, P=0.033); blood reflux time had difference: total femoral vein(t=10.12,P=0.000), superficial femoral vein(t=10.54, P= 0.000), iliac vein(t=10.86, P= 0.001); maximum reflux velocity comparison had difference:(total femoral vein(t= 8.74, P=0.000), superficial femoral vein(t=11.12, P=0.000), iliac vein(t=8.52, P=0.000). Conclusion Color Doppler ultrasonography has a high accuracy in the diagnosis of primary deep venous insufficiency of the lower extremities and can be used as the first choice.
Objective To investigate the diagnosis of primary deep venous insufficiency of lower extremity by color Doppler ultrasonography. Methods From January 2017 to January 2018, 112 case patients in our hospital were selected. The patients with symptoms of lower extremity swelling, pigmentation and ulcer were convenient selected as the case group. 76 patients showed primary deep venous valve of lower extremity. Incomplete function excludes 48 deep veins of the lower extremity as a case group, and 36 cases of 62 deep veins of the lower extremity in the normal population as a control group.Color Doppler ultrasound was used to measure and compare vessel inner diameter, mean blood flow velocity, blood reflux time, and maximum reflux velocity. Results Four groups of data(vascular diameter, mean blood flow velocity, blood reflux time and maximum reflux velocity): total femoral vein(7.61±0.85)mm,(6.42±0.84)cm/s,(722±339)ms,(13.00±0.92)cm/s, super ficial femoral vein(7.02±0.42)mm,(5.22±0.93)cm/s,(521±279)ms,(11.67±6.07)cm/s, iliac vein(9.38±0.69)mm,(6.70±1.10)cm/s,(590±334)ms,(9.65±2.59)cm/s. Data from the control group: total femoral vein(5.96±0.76)mm,(10.50±2.31)cm/s,(58±119)ms,(1.29±2.47)cm/s, superficial femoral vein(4.03 ±1.14)mm,(8.71±1.59)cm/s,(25.80 ±76.31)ms,(0.53±1.53)cm/s, iliac vein(6.55±1.41)mm,(9.67±3.49)cm/s,(22.92±65.11)ms,(0.50±1.37)cm/s. The difference in blood vessel diameter was statistically significant: total femoral vein(t=7.49, P=0.021), superficial femoral vein(t=8.12, P=0.017), iliac vein(t=4.81,P=0.023);mean blood flow had difference in speed was statistically significant: total femoral vein(t =8.23, P =0.007), superficial femoral vein(t=6.67, P=0.018), iliac vein(t=2.06, P=0.033); blood reflux time had difference: total femoral vein(t=10.12,P=0.000), superficial femoral vein(t=10.54, P= 0.000), iliac vein(t=10.86, P= 0.001); maximum reflux velocity comparison had difference:(total femoral vein(t= 8.74, P=0.000), superficial femoral vein(t=11.12, P=0.000), iliac vein(t=8.52, P=0.000). Conclusion Color Doppler ultrasonography has a high accuracy in the diagnosis of primary deep venous insufficiency of the lower extremities and can be used as the first choice.
引文
[1]张依然,勇强.超声诊断下肢深静脉血栓形成的研究进展[J].血管与腔内血管外科杂志,2017,3(2):683-684.
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[3]马芳,许继梅,刘咸罗.彩色多普勒超声对下肢交通支静脉功能不全的诊疗价值[J].中国超声医学杂志,2018,34(4):346-349.
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[5] Us M,Basaran M,Sanioglu S, Ogus NT, Ozbek C,Yildirim T,Selimoglu O,Kaya Z.The use of external banding increases the durability of transcommissural external deep venous valve repair[J].Eur J Vasc Endovasc Surg,2007,33(4):494-501.
[6]邱璇,张莉,阴继凯,等,等.超声影像评价大隐静脉曲张患者下肢静脉形态与功能变化的相关性研究[J].中华全科医学,2015,13(7):1163-1165,1184,1211.
[7]吴桢妹.彩色多普勒超声在下肢深静脉血栓诊断中的应用价值分析[J].医学理论与实践,2017,30(22):3393-3394.
[8]辛艳芬,蒲英梅,陈玉祥,等.彩色多普勒超声与X线顺行静脉造影诊断下肢穿静脉瓣膜功能不全的对比研究[J].华西医学,2017,32(11):1744-1748.
[9]邱璇.超声影像学技术评价下肢静脉曲张患者穿静脉及相关静脉形态与功能的应用研究[D].西安:第四军医大学,2015.
[10]周会.彩色多普勒超声在下肢大隐静脉曲张诊断中的应用价值[J].中国煤炭工业医学杂志,2017,20(2):176-178.
[2]李惠园,赵丽.彩色多普勒超声诊断下肢深静脉瓣功能不全的临床分析[J].医学理论与实践,2012,25(15):1897-1898.
[3]马芳,许继梅,刘咸罗.彩色多普勒超声对下肢交通支静脉功能不全的诊疗价值[J].中国超声医学杂志,2018,34(4):346-349.
[4]庞海燕.超声对下肢静脉瓣膜功能不全的临床分析[J].中国医药指南,2016,14(17):176.
[5] Us M,Basaran M,Sanioglu S, Ogus NT, Ozbek C,Yildirim T,Selimoglu O,Kaya Z.The use of external banding increases the durability of transcommissural external deep venous valve repair[J].Eur J Vasc Endovasc Surg,2007,33(4):494-501.
[6]邱璇,张莉,阴继凯,等,等.超声影像评价大隐静脉曲张患者下肢静脉形态与功能变化的相关性研究[J].中华全科医学,2015,13(7):1163-1165,1184,1211.
[7]吴桢妹.彩色多普勒超声在下肢深静脉血栓诊断中的应用价值分析[J].医学理论与实践,2017,30(22):3393-3394.
[8]辛艳芬,蒲英梅,陈玉祥,等.彩色多普勒超声与X线顺行静脉造影诊断下肢穿静脉瓣膜功能不全的对比研究[J].华西医学,2017,32(11):1744-1748.
[9]邱璇.超声影像学技术评价下肢静脉曲张患者穿静脉及相关静脉形态与功能的应用研究[D].西安:第四军医大学,2015.
[10]周会.彩色多普勒超声在下肢大隐静脉曲张诊断中的应用价值[J].中国煤炭工业医学杂志,2017,20(2):176-178.