下肢慢性静脉功能不全严重程度与超声结果的关系  

The Relationship between the Severity of Chronic Venous Insufficiency in the Lower Limbs and Ultrasound Results

作　　者：刘志强 米雨 汪轶亭 孙功能[1] LIU Zhiqiang;MI Yu;WANG Yiting;SUN Gongneng(Department of Interventional Vascular,the Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui,P.R.China;Department of Ultrasound Medicine,the Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui,P.R.China)

机构地区：[1]安徽医科大学附属巢湖医院介入血管科,安徽巢湖238000 [2]安徽医科大学附属巢湖医院超声医学科,安徽巢湖238000

出　　处：《影像科学与光化学》2024年第3期269-275,共7页Imaging Science and Photochemistry

摘　　要：目的:探讨下肢静脉功能不全的患者临床严重程度与超声检查结果的关系。方法:选取2022年1月至2023年6月在我院住院就诊的下肢静脉功能不全的285例患者,对所有患者的超声检查进行回顾,并依据临床、病因、解剖-病理(CEAP)分级、静脉临床严重程度评分(VCSS)和HASTI评分来评估患者的临床严重程度。结果:通过回顾性分析285例患者(463条患肢),研究发现重度静脉功能不全的风险与年龄、体质量指数(BMI)和糖尿病相关。超过60%的患肢有大隐静脉反流,有54.86%的患肢有穿支静脉反流,大隐静脉反流和穿支静脉反流与静脉功能不全的严重程度显著相关,重度静脉功能不全的患肢大隐静脉、小隐静脉、穿支静脉直径均显著高于轻中度,重度静脉功能不全的患肢大隐静脉反流时间、穿支静脉反流时间、股静脉反流时间显著大于轻中度。大隐静脉直径、穿支静脉直径和反流时间与VCSS和HASTI评分成正相关。结论:重度慢性静脉功能不全的超声阳性检出率更高,结果可作为静脉功能不全严重程度的客观评价指标。Objective:Explore the relationship between clinical severity and ultrasound examination results in patients with lower limb venous insufficiency.Methods:Selected a total of 285 patients with lower limb venous insufficiency who were hospitalized in our hospital from January 2022 to June 2023,reviewed the ultrasound examinations of all patients,and evaluated their clinical severity based on clinical,etiology,anatomical pathological grading,venous clinical severity score(VCSS),and Heaviness,Achiness,Swelling,Throbbing,Itching score.Results:By retrospective analysis of 285 patients(463 limbs),the study found that severe venous insufficiency was associated with age,body mass index and diabetes.Among the CEAP grading,the most common one is C2 grade(59.17%),with over 60%of affected limbs having greater saphenous vein reflux and 54.86%having perforating vein reflux.Significant correlations were found between greater saphenous vein reflux and the severity of venous insufficiency(P<0.001),as well as between perforating vein reflux and the severity(P<0.001).Additionally,the diameters of the great saphenous vein,small saphenous vein,and perforating veins were significantly higher in limbs with severe venous insufficiency compared to those with mild to moderate insufficiency. Similarly, reflux times for these veins were significantly longer in severe cases. A positive correlation was observed between vessel diameters, reflux times, and both VCSS and HASTI scores. Conclusion: Ultrasound examination demonstrated a higher detection rate in cases of severe chronic venous insufficiency, indicating its potential as an objective evaluation indicator for the severity of venous insufficiency.

关 键 词：慢性静脉功能不全 CEAP分级 彩色多普勒超声 静脉反流 

分 类 号：R543.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]