| 超声结合临床评价下肢深静脉血栓稳定性及危险因素分析 |
| 投稿时间：2017-12-03 修订日期：2017-12-19 点此下载全文 |
| 引用本文：张晓琳,张莹,马琳,孙玉伟,王艺桦.超声结合临床评价下肢深静脉血栓稳定性及危险因素分析[J].医学研究杂志,2018,47(9):155-159 |
| DOI：
10.11969/j.issn.1673-548X.2018.09.037 |
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| 中文摘要:目的 分析超声声像图特点及临床特点，为评价下肢深静脉血栓是否稳定提供依据。方法 回顾性分析经超声诊断下肢深静脉血栓（deep venous thrombosis， DVT）患者87例，根据回收的下腔静脉滤器内有无脱落血栓分为两组，Ⅰ组：血栓不稳定组，42例，Ⅱ组：血栓稳定组，45例。分析比较两组DVT发生部位、血栓回声特点、管腔内血流充盈情况、生化指标等特点。采用Logistic回归分析寻找影响DVT稳定性的危险因素。结果 下腔静脉滤器置入术前，两组声像图特点比较，差异无统计学意义（P>0.05）。下腔静脉滤器置入术前与取出术前，两组声像图特点前后变化情况比较， DVT发生部位有变化差异有统计学意义（P<0.05），Ⅰ组DVT发生部位有变化的比率高于Ⅱ组。生化指标比较血浆D-二聚体（D-D）、血浆凝血酶原时间（PT）、甘油三酯（TG）、脂蛋白α（Lpα）比较，差异有统计学意义（P<0.05），Ⅰ组TG低于Ⅱ组，Ⅰ组Lpα、D-D高于Ⅱ组，Ⅰ组PT长于Ⅱ组。非条件Logistic回归结果显示D-D高、PT延长、血栓发生部位有变化、既往有血栓病史是导致血栓不稳定的危险因素。结论 两组DVT在滤器置入术前声像图特点类似；超声动态观察DVT发生部位有变化者同时结合D-D高、PT时间延长、既往有血栓病史等特点可有助于判断DVT不稳定。 |
| 中文关键词:超声检查 深静脉血栓 血浆D-二聚体 |
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| Analysis of Ultrasound Combined With Clinical Evaluation of Deep Venous Thrombosis of the Lower Extremity Stability and Risk Factors |
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| Abstract:Objective To analyze the characteristics of ultrasonography and clinical in order to evaluate the stability of deep venous thrombosis(DVT) of lower extremity. Methods The ultrasonic diagnosis of 87 cases of lower extremity deep venous thrombosis patients was performed.According to whether the interception of thrombus of inferior vena cava filter inside, the patients were divided into two groups. Group Ⅰ:unstable thrombus group, there were 42 cases, and group Ⅱ:thrombus stabilization group, 45 cases.Analysis and comparison of two groups of DVT sites, thrombus echo characteristics, Filling in the intraluminal blood flow, biochemical indices etc was carried out.Logistic regression analysis of risk factors for thrombotic instability was performed. Results There was no significant difference in ultrasound characteristics between the two groups before implantation of the inferior vena cava filter (P>0.05).Comparing the sonographic characteristics of the two groups, the location of DVT changed before the inferior vena cava filter placement and the inferior vena cava filter removal, and the difference was statistically significant.(P<0.05).The comparison of biochemical indicators showed that plasma D- dimer (D-D), plasma prothrombin time (PT), triglyceride (TG) and lipoprotein alpha (Lp alpha) were significantly different(P<0.05).Non-conditional Logistic regression showed that high D-D, prolonged PT, changes in the site of thrombus, and previous history of thrombus were the risk factors for thrombosis instability. Conclusion The characteristics of the two groups of DVT before the inferior vena cava filter were similar.It is helpful to judge the instability of deep venous thrombosis in the lower extremities,which changes in the location of thrombus by ultrasonic dynamic observation,combined with high D-D, PT lengthening, and the history of thrombus. |
| keywords:Ultrasonography Deep venous thrombosis (DVT) D-dimer (D-D) |
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