急诊床旁超声对疑似下肢深静脉血栓的诊断价值  

Diagnostic value of emergency bedside ultrasound in suspected lower extremity deep vein thrombosis

作　　者：杨竹馨 王勇 韩小军 田黎 冉龙飞 漆雨含 邹晓攀[1] 白斗[2] 刘丹[3] Yang Zhuxin;Wang Yong;Han Xiaojun;Tian Li;Ran Longfei;Qi Yuhan;Zou Xiaopan;Bai Dou;Liu Dan(Department of Ultrasound,Mianyang Central Hospital,Mianyang 621000,Sichuan,China;Department of Vascular Surgery,Mianyang Central Hospital,Mianyang 621000,Sichuan,China;Emergency ICU of Mianyang Central Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市中心医院超声科,四川绵阳621000 [2]绵阳市中心医院血管外科,四川绵阳621000 [3]绵阳市中心医院急诊ICU,四川绵阳621000

出　　处：《血管与腔内血管外科杂志》2025年第1期137-140,共4页Journal of Vascular and Endovascular Surgery

摘　　要：目的 探讨急诊床旁超声对疑似下肢深静脉血栓(DVT)的诊断价值。方法 收集2020年2月至2022年3月于绵阳市中心医院就诊的76例疑似下肢DVT高危患者的临床资料,所有患者均进行床旁超声检查,采用住院期间下肢DVT的D二聚体检测结果联合超声检查结果作为最终下肢DVT的诊断结果,评估急诊床旁超声检查结果,计算急诊床旁超声对下肢DVT的诊断效能。结果 76例疑似下肢DVT高危患者中,急诊床旁超声共诊断下肢DVT患者33例,住院期间共确诊32例,其中,经下肢深静脉超声检查联合D-二聚体升高确诊25例,下肢深静脉血管造影确诊7例。急诊床旁超声诊断下肢DVT的符合率为93.4%,不一致率为6.6%,Kappa指数为0.866,灵敏度为93.8%,特异度为93.2%,漏诊率为6.3%,误诊率为6.8%,Youden指数为0.869,阳性预测价值为90.9%,阴性预测价值为95.3%。结论 急诊床旁超声对下肢DVT具有较高的诊断效能,值得在临床上进一步推广应用。Objective To investigate the diagnostic value of emergency bedside ultrasound for suspected deep vein thrombosis of lower extremities(DVT).Method Clinical data of 76 patients suspected to be high-risk patients with DVT of lower extremity were collected from Mianyang Central Hospital from February 2020 to March 2022.Bedside ultrasound examination was performed on all patients.The D-dimer detection results of DVT of lower limbs combined with ultrasonography results during hospitalization were used as the final diagnosis result of DVT of lower extremity.The results of emergency bedside ultrasound were evaluated,and the diagnostic efficacy of emergency bedside ultrasound in diagnosing DVT of lower extremity was calculated.Result Among 76 suspected high-risk patients with DVT in lower extremity,33 cases were diagnosed with DVT in lower extremity by emergency bedside ultrasound,and 32 cases were diagnosed during hospitalization,of which 25 cases were diagnosed by deep venous ultrasonography in lower extremity combined with D-dimer elevation,and 7 cases were confirmed by deep venous angiography in lower extremity.The conformity rate of emergency bedside ultrasound diagnosis for lower extremity DVT was 93.4%,the inconsistency rate was 6.6%,the Kappa index was 0.866,the sensitivity was 93.8%,the specificity was 93.2%,the missed diagnosis rate was 6.3%,the misdiagnosis rate was 6.8%,the Youden index was 0.869,the positive predictive value was 90.9%,and the negative predictive value was 95.3%.Conclusion Emergency bedside ultrasound has a high clinical application value for lower extremity DVT,which is worth further promotion and application in clinical practice.

关 键 词：急诊床旁超声 下肢深静脉血栓 诊断价值 

分 类 号：R543[医药卫生—心血管疾病]