超声评价下肢慢性静脉疾病髂总静脉形态及血流动力学参数的临床价值  

Clinical value of ultrasonography in evaluating the morphology and hemodynamic parameters of common iliac vein in patients with chronic venous diseases of lower limbs

作　　者：武天娇 李燕[2] 赵艳琴[1] 毕伟[2] 赵雅培[1] Wu Tianjiao;Li Yan;Zhao Yanqin;Bi Wei;Zhao Yapei(Department of Ultrasound,the East Branch of the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China;Department of Vascular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第二医院东院区超声科,石家庄050000 [2]河北医科大学第二医院血管外科,石家庄050000

出　　处：《血管与腔内血管外科杂志》2022年第7期795-799,805,共6页Journal of Vascular and Endovascular Surgery

基　　金：河北医科大学第二医院科学研究基金项目(2HC202127)。

摘　　要：目的利用超声探讨非髂静脉压迫综合征(IVCS)所致下肢慢性静脉疾病(CVD)对髂总静脉(CIV)形态及血流动力学参数的影响,并分析患肢临床表现-病因学-解剖学-病理生理学(CEAP)临床分级与各参数的相关性。方法选取2019年12月至2021年1月于河北医科大学第二医院就诊的115例(患肢211条)下肢CVD患者为病例组,根据患肢侧别将病例组患者分为L组(n=102)和R组(n=109),并根据CEAP临床分级及压迫治疗方案将病例组患肢分为3个亚组,即R-Ⅰ组(患肢38条),L-Ⅰ组(患肢29条);R-Ⅱ组(患肢39条),L-Ⅱ组(患肢37条);R-Ⅲ组(患肢32条),L-Ⅲ组(患肢36条)。另选取97例同期与病例组相匹配的下肢健康者为对照组,并分为对照R组88条和对照L组89条。结果病例组左侧和右侧CIV的最小直径、周长、面积、静脉血流量(VBF)均大于对照组,R组的最大直径大于对照R组(P<0.05)。右侧患肢的CEAP临床分级与年龄呈弱正相关(r=0.197,P<0.05)。左侧患肢的CEAP临床分级与BSA呈弱正相关(r=0.204,P<0.05),与左侧CIV的最大血流速度(Vmax)、VBF呈弱正相关(r=0.254、0.225,P<0.05)。L-Ⅰ组与L-Ⅲ组的性别比较,差异有统计学意义(P<0.05)。结论通过超声检查评估显示下肢CVD可影响CIV的形态及血流动力学参数,且左侧患肢的CEAP临床分级与同侧CIV的改变具有一定的相关性。Objective To investigate the effect of lower limbs chronic venous disease(CVD) caused by non-iliac vein compression syndrome(IVCS) on the morphology and hemodynamic parameters of common iliac vein(CIV) by ultrasonography and study the correlation between the clinical classification of clinical-etiology-anatomy-pathophysiology(CEAP) and the parameters. Method A total of 115(211 limbs) patients with CVD of the lower limbs in the Second Hospital of Hebei Medical University from December 2019 to January 2021 were selected as case group. The patients in the case group were divided into L group(n=102) and R group(n=109) according to the side of the affected lower limb, and then the group was divided into three subgroups according to the compression treatment standard of the CEAP clinical classification: group R-Ⅰ(38 limbs), group L-Ⅰ(29 limbs), group R-Ⅱ(39 limbs), group L-Ⅱ(37 limbs), group R-Ⅲ(32 limbs), group L-Ⅲ(36 limbs). In the same period, 97 cases lower limb healthy persons matched by the case group of patients were divided into the control group, which was further divided into control group R(88 limbs) and control group L(89 limbs). Result The minimum diameter, circumference, area and vein blood flow(VBF) of left and right CIV in case group were higher than those in the control group, maximum diameter of the group R larger than that of the control group R(P<0.05). In patients with the right lower limb CVD, CEAP clinical classification was weakly positively correlated with age(r=0.197, P<0.05). In patients with the left lower limb CVD, CEAP clinical classification was weakly positively correlated with BSA(r=0.204, P<0.05), and with the maximum blood flow velocity(Vmax) and VBF of the left CIV(r=0.254, 0.225, P<0.05). There was statistical significance between the gender ratio of group L-Ⅰ and group L-Ⅲ(P<0.05). Conclusion Ultrasonic evaluation shows that CVD of the lower limbs could affect the morphology and hemodynamic parameters of the common iliac vein, and CEAP clinical classification of the

关 键 词：超声 髂静脉压迫综合征 慢性静脉疾病 髂总静脉 相关性 

分 类 号：R543[医药卫生—心血管疾病]