超声检查对骨折患者下肢深静脉漂浮血栓脱落的诊断意义  

Diagnostic significance of ultrasonography on free-floating thrombus shedding in deep vein of lower extremity in fracture patients

作　　者：徐杨 袁宇[1] 高金妹[1] XU Yang;YUAN Yu;GAO Jinmei(Department of Ultrasound,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院超声科,300211

出　　处：《天津医药》2024年第5期548-551,共4页Tianjin Medical Journal

摘　　要：目的探讨超声检查对骨折患者下肢深静脉(DV)漂浮血栓脱落的诊断意义。方法收集127例下肢DV漂浮血栓并植入下腔静脉过滤器(IVCF)的患者超声资料及临床资料。超声资料包括血栓的回声、活动程度、长度、位置、侧别及彩色多普勒情况;临床资料包括性别、年龄、骨折部位、凝血酶时间(TT)、D-二聚体(D-D)、纤维蛋白原(FIB)。采用Logistic回归分析DV漂浮血栓患者发生血栓脱落的影响因素(P<0.05)。结果根据IVCF内有无脱落血栓将患者分为血栓脱落组51例,血栓未脱落组76例。血栓呈极低回声、血栓活动程度为漂浮或轻微漂浮是DV漂浮血栓脱落的独立危险因素。血栓呈极低回声的患者发生脱落的风险是血栓呈中等回声患者的4.182倍(95%CI:1.209~14.468,P=0.024),血栓活动程度为轻微漂浮或漂浮的患者血栓脱落的风险分别是血栓头端漂浮患者的4.979倍(95%CI:1.851~13.391,P=0.001)和11.373倍(95%CI:3.936~32.863,P<0.001)。结论超声指标血栓回声及血栓活动程度对外伤性骨折患者DV漂浮血栓脱落具有一定的诊断意义。Objective To explore the diagnostic significance of ultrasonography on free-floating thrombus in deep vein(DV)shedding of lower extremity in fracture patients.Methods The ultrasound and clinical data were collected from 127 patients with lower extremity free-floating DV thrombosis and implantation of inferior vena cava filter(IVCF).The ultrasound data included the echo and activity of thrombus,thrombus activity,thrombus length,thrombus location,thrombus side and thrombus color Doppler imaging.Clinical data included gender,age,fracture site,thrombin time(TT),D-dimer(DD)and fibrinogen(FIB).The Logistic regression model was used to analyze influencing factors of thrombus shedding in patients with floating DV thrombus(P<0.05).Results Patients were divided into two groups based on the presence or absence of thrombus shedding in IVCF.There were 51 patients in the thrombus shedding group and 76 patients in the nonthrombus shedding group.Thrombus was extremely low echogenicity.Thrombus activity was floating or slightly floating was independent risk factors for DV floating thrombus shedding.Patients with extremely low echogenicity of thrombus were 4.182 times higher probability of thrombus shedding than those with moderate echogenicity(95%CI:1.209-14.468,P=0.024).Patients with slightly floating or floating thrombus had a 4.979 times higher(95%CI:1.851-13.391,P=0.001)and 11.373 times higher probability of thrombus shedding(95%CI:3.936-32.863,P<0.001)than those with the tip of thrombus floating,respectively.Conclusion Ultrasonic indicators such as thrombus echo and thrombus activity have certain significance in the diagnosis of DV free-floating thrombus shedding in patients with traumatic fracture.

关 键 词：静脉血栓形成 超声检查 危险因素 漂浮血栓 脱落 

分 类 号：R445.14[医药卫生—影像医学与核医学]