超声心动图与外周血管超声联合诊断心胸外科术后静脉血栓栓塞症的诊断效能  

Diagnostic efficacy of combination of echocardiography and peripheral vascular ultrasound in diagnosis of venous thromboembolism after cardiothoracic surgery

作　　者：陈薇[1] 郑建华[1] 方荔香 陈振东[1] 陈海兰[1] 翁育娟[1] 曾宸 Chen Wei;Zheng Jianhua;Fang Lixiang;Chen Zhendong;Chen Hailan;Weng Yujuan;Zeng Chen(Department of Ultrasound,the Affiliated Hospital of Putian University,Putian,Fujian 351100,China.)

机构地区：[1]莆田学院附属医院超声科,福建莆田351100

出　　处：《齐齐哈尔医学院学报》2024年第6期563-566,共4页Journal of Qiqihar Medical University

基　　金：莆田学院科技项目(2022080)。

摘　　要：目的 探究超声心动图与外周血管超声联合诊断心胸外科术后静脉血栓栓塞症的诊断效能。方法 选择2021年3月—2023年3月本院收治的104例疑似静脉血栓栓塞患者为研究对象,按肺动脉CT血管造影(CTPA)和下肢多普勒超声检查结果分为病例组(44例)和对照组(60例)两组。比较两组患者一般资料及实验室相关指标,单因素和多因素分析法进行静脉血栓栓塞症危险因素分析,评价超声心动图与外周血管超声联合诊断心胸外科术后静脉血栓栓塞症的诊断效能。结果 两组患者D-二聚体、肺动脉压力及动脉血二氧化碳分压比较,差异具有统计学意义(P<0.05)。下肢DVT、PAH和D-二聚体升高与静脉血栓栓塞症的OR值分别为1.123、1.022和9.076,可见下肢DVT、PAH和D-二聚体升高是静脉血栓栓塞症的独立危险因素。下肢DVT、三尖瓣反流、PAH及三者联合诊断静脉血栓栓塞症的AUC分别为0.635、0.647、0.621和0.827,可见下肢DVT、三尖瓣反流和PAH三者联合诊断静脉血栓栓塞症具有较高的诊断效能。结论 超声心动图与外周血管超声联合应用对诊断心胸外科术后静脉血栓栓塞症具有一定的诊断效能,值得推广应用。Objective To explore the diagnostic efficacy of combined echocardiography and peripheral vascular ultrasound in the diagnosis of venous thromboembolism after cardiothoracic surgery.Methods 104 patients with suspected venous thromboembolism who were admitted to our hospital from March 2021 to March 2023 were selected as the research subjects.They were divided into the case group(n=44)and the control group(n=60)based on the results of pulmonary artery CT angiography(CTPA)and lower limb Doppler ultrasound examination.The general information and laboratory related indicators of the two groups were compared,and the risk factors of venous thromboembolism were analyzed using univariate and multivariate analysis methods.The diagnostic efficacy of echocardiography combined with peripheral vascular ultrasound in the diagnosis of venous thromboembolism after cardiothoracic surgery was evaluated.Results There were significant differences in D-dimer,pulmonary artery pressure and arterial blood partial pressure of carbon dioxide between the two groups(P<0.05).The OR values of elevated DVT,PAH,and D-dimer in lower limbs and venous thromboembolism were 1.123,1.022,and 9.076,respectively.It can be seen that the increase of DVT,PAH,and D-dimer in lower limbs were independent risk factors for venous thromboembolism.The AUC of lower limb DVT,Tricuspid valve regurgitation,PAH and their combination in the diagnosis of venous thromboembolism were 0.635,0.647,0.621 and 0.827,respectively.It could be seen that the combination of lower limb DVT,Tricuspid valve regurgitation and PAH had a high diagnostic efficiency in the diagnosis of venous thromboembolism.Conclusions The combination of echocardiography and peripheral vascular ultrasound has certain diagnostic efficacy in the diagnosis of venous thromboembolism after cardiothoracic surgery,and is worthy of promotion and application.

关 键 词：超声心动图 外周血管超声 静脉血栓栓塞 诊断效能 

分 类 号：R654.4[医药卫生—外科学]