超声参数静脉管腔横截周长的平方与面积的比值对骨科住院患者下肢深静脉血栓的预测价值  

Predictive value of the ratio of square of the cross-sectional perimeter and area of the venous lumen measured by ultrasound for the lower limb deep vein thrombosis in orthopedic inpatients

作　　者：陈曦 安丽 谷芬 田丰 刘丽文 CHEN Xi;AN Li;GU Fen;TIAN Feng;LIU Liwen(Department of Ultrasound,the First Affiliated Hospital of the Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学第一附属医院超声医学科,西安市710032

出　　处：《临床超声医学杂志》2023年第5期351-355,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(82071932)。

摘　　要：目的应用超声测量静脉管腔横截周长(C)、面积(A),计算C^(2)/A,探讨该参数对骨科住院患者下肢深静脉血栓的预测价值。方法选取于我院骨科拟行手术的无血栓住院患者150例,其中术后7 d内发生血栓37例(血栓组),未发生血栓113例(无血栓组);比较两组术前超声参数包括股总静脉(CFV)、股静脉(FV)、腘静脉(POV)C、A、C^(2)/A、流速及内径的差异;绘制受试者工作特征(ROC)曲线分析CFV、FV、POV各超声参数预测下肢深静脉血栓的诊断效能。结果与无血栓组比较,血栓组CFV内径、CFV-C、CFV-C^(2)/A、FV-C、FV-C^(2)/A、POV-C、POV-A和POV-C^(2)/A均增加,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,当CFV-C^(2)/A、FV-C^(2)/A、POV-C^(2)/A截断值分别为>17.2、17.1、17.1,预测下肢深静脉血栓的曲线下面积分别为0.953[95%可信区间(CI):0.922~0.974,P<0.001]、0.933(95%CI:0.899~0.959,P<0.001)、0.919(95%CI:0.882~0.947,P<0.001),灵敏度分别为93.2%、95.5%、88.6%,特异度分别为94.1%、89.8%、91.0%。结论超声参数C^(2)/A对骨科住院患者下肢深静脉血栓有一定的预测价值。Objective To measure the ratio of square of cross-sectional perimeter and area(C^(2)/A)of the venous lumen by ultrasound,and to explore its predictive value for lower limb deep vein thrombosis(DVT)in orthopedic inpatients.Methods Totally 150 inpatients without DVT who were selected for orthopedic surgery in our hospital were enrolled.Among them,37 patients developed thrombosis within 7 d after surgery(thrombotic group)and 113 patients did not develop thrombosis(non-thrombotic group).The preoperative ultrasound parameters including cross-sectional perimeter(C),cross-sectional area(A)and C^(2)/A,flow velocity,internal diameter of common femoral vein(CFV),femoral vein(FV)and popliteal vein(POV)were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of each ultrasound parameter of CFV,FV,POV in predicting lower limb DVT.Results Compared with the non-DVT group,the CFV inner diameter,CFV-C,CFV-C^(2)/A,FV-C,FV-C^(2)/A,POV-C,POV-A and POV-C^(2)/A were all increased in the DVT group,and the differences were statistically significant(all P<0.05).ROC curve analysis showed that when the cutoff of CFV-C^(2)/A,FV-C^(2)/A,POV-C^(2)/A were 17.2,17.1 and 17.1,respectively,the area under the curve for predicting lower limb DVT were 0.953(95%CI:0.922~0.974,P<0.001),0.933(95%CI:0.899~0.959,P<0.001)and 0.919(95%CI:0.882~0.947,P<0.001),respectively.The sensitivity were 93.2%,95.5%and 88.6%,respectively,the specificity were 94.1%,89.8%and 91.0%,respectively.Conclusion C^(2)/A measured by ultrasound has a certain predictive value for DVT in orthopedic inpatients.

关 键 词：超声检查 下肢深静脉 血栓前状态 

分 类 号：R445.1[医药卫生—影像医学与核医学] R683.4[医药卫生—诊断学]