彩色多普勒超声在老年恶性肿瘤患者下肢深静脉血栓中的诊断效能及相关危险因素分析  

Diagnostic efficiency of color Doppler ultrasound on lower extremity deep venous thrombosis in elderly patients with malignant tumors and analysis of related risk factors

作　　者：陈伟伟[1] 吴晓恬 葛舒 于洪波[2] 姜倩[1] Chen Weiwei;Wu Xiaotian;Ge Shu;Yu Hongbo;Jiang Qian(Department of Ultrasound,Nantong Tumor Hospital,Nantong 226361,Jiangsu,China;Department of Intervention,Nantong Tumor Hospital,Nantong 226361,Jiangsu,China)

机构地区：[1]南通市肿瘤医院超声科,江苏南通226361 [2]南通市肿瘤医院介入科,江苏南通226361

出　　处：《血管与腔内血管外科杂志》2025年第1期108-112,共5页Journal of Vascular and Endovascular Surgery

基　　金：基础研究计划(自然科学基金)——面上研究项目(BK20161291)。

摘　　要：目的 探讨彩色多普勒超声在老年恶性肿瘤患者下肢深静脉血栓(DVT)中的诊断效能及相关危险因素。方法 收集2021年3月至2024年3月于南通市肿瘤医院就诊的200例恶性肿瘤患者的临床资料,按照住院期间是否发生下肢DVT将患者分为观察组(n=63,存在DVT)和对照组(n=137,无DVT),分析彩色多普勒超声对老年恶性肿瘤患者下肢DVT的诊断效能以及老年恶性肿瘤患者住院期间下肢DVT形成的危险因素。结果 D-二聚体(D-D)联合彩色多普勒超声首次检查结果提示下肢DVT患者61例,无下肢DVT患者139例,对无明显下肢DVT但高度怀疑存在患有DVT可能性的患者进行再次超声检查,结果显示下肢DVT患者63例,无下肢DVT患者137例。首次彩色多普勒超声诊断老年恶性肿瘤患者下肢DVT的灵敏度为96.8%(61/63),特异度为100%(137/137),与两次彩色多普勒超声检查诊断下肢DVT的Kappa值为0.977。单因素分析结果显示,观察组患者糖尿病、近期手术外伤史、下肢功能障碍的比例以及入院时D-D水平均高于对照组患者,差异均有统计学意义(P<0.05)。多因素分析结果显示,糖尿病、近期手术外伤史、下肢功能障碍及D-D水平≥0.5 mg/L均是老年恶性肿瘤患者住院期间发生下肢DVT的独立危险因素(P<0.05)。结论 彩色多普勒超声对老年恶性肿瘤患者下肢DVT的诊断效能较好,糖尿病、近期手术外伤史、下肢功能障碍、D-D水平均与老年恶性肿瘤患者住院期间发生下肢DVT密切相关,在临床治疗中应密切监测上述危险因素,并积极给予预防性措施,减少老年恶性肿瘤患者住院期间下肢DVT的形成。Objective To investigate the diagnostic efficiency of color Doppler ultrasound on lower extremity deep vein thrombosis(DVT)in elderly patients with malignant tumors and the related risk factors.Method The clinical data of 200 malignant tumor patients who visited Nantong Tumor Hospital from March 2021 to March 2024 were collected.The patients were divided into observation group(n=63,with DVT)and control group(n=137,without DVT)based on whether DVT occurred during hospitalization.The diagnostic efficacy of color Doppler ultrasound on lower extremity DVT in elderly malignant tumor patients and related risk factors for the formation of lower extremity DVT in elderly malignant tumor patients during hospitalization was analyzed.Result The first examination results of D-dimer(D-D)combined with color Doppler ultrasound suggested that there were 61 cases with lower extremity DVT and 139 cases without lower extremity DVT.The second ultrasound examination on patients without lower extremity DVT but with high possibility of DVT,and it was found that there were 63 patients with lower extremity DVT and 137 patients without lower extremity DVT.The sensitivity,specificity of the first color Doppler ultrasound in the diagnosis of lower extremity DVT in elderly patients with malignant tumors were 96.8%(61/63),100%(137/137),and the Kappa value of 0.977 compared to two color Doppler ultrasound examinations for the diagnosis of lower extremity DVT.The results of univariate analysis showed that the proportion of diabetes,the proportion of recent history of surgical trauma,the proportion of lower extremity dysfunction and D-D level at admission in the observation group were higher than those in the control group,the differences are statistically significant(P<0.05).Multivariate analysis indicated that diabetes mellitus,recent history of surgical trauma,lower extremity dysfunction and D-D level≥0.5 mg/L were independent risk factors for lower extremity DVT in elderly patients with malignant tumors during hospitalization(P<0.05).Conclu

关 键 词：老年 恶性肿瘤 下肢深静脉血栓 彩色多普勒超声 诊断效能 危险因素 

分 类 号：R543[医药卫生—心血管疾病]