多普勒超声对下肢慢性静脉功能不全症患者中髂静脉压迫的预测价值  

Predictive value of doppler ultrasound on iliac vein compression in patients with chronic venous insufficiency of lower extremity

作　　者：苏翔[1] 孙学余 裘益辉[1] 杨法镜[1] 潘乐门[1] 郑祥韬[1] SU Xiang;SUN Xueyu;QIU Yihui;YANG Fajing;PAN Lemen;ZHENG Xiangtao(Department of Vascular Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou325000,China)

机构地区：[1]温州医科大学附属第一医院血管外科,浙江温州325000

出　　处：《中国现代医生》2020年第30期22-27,共6页China Modern Doctor

基　　金：国家自然科学基金资助项目(81770409);浙江省温州市科技计划项目(Y20170395)。

摘　　要：目的探讨多普勒超声诊断髂静脉压迫综合征的价值。方法选取2017年10月~2019年9月我院治疗的下外周慢性静脉功能不全症患者402例,行多普勒超声和顺行静脉造影检查,以静脉造影结果为诊断标准,将402例患者分为髂静脉压迫组和对照组。分析多普勒超声诊断髂静脉压迫综合征的价值。结果髂静脉压迫综合征患者的多普勒超声诊断总灵敏度为73.6%,特异度为93.7%。比较髂静脉压迫组与对照组的超声数据,结果显示几个指标可帮助诊断髂静脉压迫:左髂静脉最狭窄处与狭窄后血流峰速比值>2.000的灵敏度为92.13(84.50~96.80),特异度为95.83(93.0~97.8);右髂静脉与左髂静脉分叉处血流峰速比值>1.500的灵敏度为69.32(58.60~78.70),特异度为80.77(76.00~85.00);Valsalva动作后左股总静脉血流峰速变化比值<2的灵敏度为92.10%,特异度为84.80%,阳性似然比为6.06,阴性似然比为0.09。结论多普勒超声是从下肢静脉功能不全患者中筛选髂静脉压迫综合征患者的合理方法。Objective To investigate the value of doppler ultrasound in diagnosing iliac vein compression syndrome.Methods A total of 402 patients with inferior and external chronic venous insufficiency from 0ctober 2017 to September 2019 were examined by doppler ultrasound and anterograde venography.According to venography,402 patients were divided into the iliac vein compression group and the control group.To analyse the value of doppler ultrasound in diagnosing iliac vein compression syndrome.Results The total sensitivity and specificity of doppler ultrasound for iliac vein compression were 73.6%and 93.7%,respectively.By comparing the ultrasound data of the iliac vein compression group and the control group,the iliac vein compression could be diagnosed by several indexes.The peak velocity ratio of left iliac vein stenosis/distal blood flow>2.0,the sensitivity of the index is 92.13(84.5-96.8),the specificity is 95.83(93.0-97.8);the peak velocity ratio of right and left iliac vein blood flow>1.5,The sensitivity was 69.32(58.6-78.7),the specificity was 80.77(76.0-85.0);the ratio of peak velocity of left femoral vein blood flow after/before valsaval action was less than 2,the sensitivity was 92.1%,the specificity was 84.8%.Conclusion Doppler ultrasound is a reasonable method to screen iliac vein compression syndrome from patients with venous insufficiency of lower extremity.

关 键 词：多普勒超声 下肢静脉顺行造影 髂静脉压迫综合征 下肢静脉功能不全 May-Thurner综合征 

分 类 号：R543.6[医药卫生—心血管疾病]