摘要
目的探讨彩色多普勒超声对儿童经外周静脉穿刺中心静脉导管(PICC)置管后血栓形成的诊断及定期随访意义。方法选取郑州大学附属儿童医院2017年1月至2019年8月实施PICC置管的150例患儿,统计随访期间的静脉导管相关性血栓形成情况,以数字减影血管造影(digital subtraction angiography,DSA)检查结果为参照,计算彩色多普勒超声对PICC置管后血栓形成的诊断结果,分析彩色多普勒超声结果与DSA检查结果间的一致性,观察不同级别血栓的超声表现。结果经DSA检查,150例PICC置管患儿中,有20例患儿形成静脉导管性血栓,血栓形成率为13.33%。参照DSA检查结果,彩色多普勒超声对PICC置管后血栓形成的诊断灵敏度为95.00%,特异度为96.15%,阳性预测值为79.17%,阴性预测值为99.21%,准确率为96.00%。一致性分析,彩色多普勒超声检查结果与DSA检查结果具有高度一致性。20例PICC置管后静脉导管性血栓中,Ⅰ级血栓11例,Ⅱ级血栓6例,Ⅲ级血栓3例,彩色多普勒超声对不同级别血栓的诊断符合率均达到100%。结论彩色多普勒超声用于PICC置管患儿随访中,可对静脉导管性血栓形成进行实时监测,对血栓情况予以及时检出和判断,具有良好的诊断价值。
Objective To investigate the value of color doppler ultrasound in the diagnosis and regular follow-up of thrombus after the placement of peripherally inserted central catheter(PICC)in children.Method From January 2017 to August 2019,150 cases of children with PICC catheterization in pediatrics of children’s hospital of Zhengzhou university were selected as the study objects.The status of venous catheter-related thrombosis during the followup was counted.According to the results of digital subtraction angiography(DSA),the diagnosis results of thrombus after PICC catheterization were calculated by color Doppler ultrasound,the consistency between the results of color Doppler ultrasound and DSA was analyzed,and the ultrasonic manifestations of different levels of thrombosis were observed.Result DSA showed that 20 cases out of 150 cases of children with PICC had venous catheter thrombus,the rate of thrombosis was 13.33%.According to the results of DSA,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of color Doppler ultrasound were 95.00%,96.15%,79.17%,99.21%and 96.00%respectively.The results of color Doppler ultrasound were highly consistent with those of DSA.Among 20 cases of venous catheter thrombus after PICC,11 cases were gradeⅠthrombus,6 cases were gradeⅡthrombus,3 cases were gradeⅢthrombus.The diagnostic accuracy of color Doppler ultrasound for different grades of thrombus was 100%.Conclusion In the follow-up of children with PICC catheterization,color Doppler ultrasound can monitor the formation of venous catheter thrombus in real time,detect and judge the thrombus in time,which has a good diagnostic value.
作者
张瑞华
霍亚玲
孙真真
王丹
Zhang Ruihua;Huo Yaling;Sun Zhenzhen;Wang Dan(Department of Ultrasound Medicine,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,He'nan,China)
出处
《血管与腔内血管外科杂志》
2020年第1期42-45,共4页
Journal of Vascular and Endovascular Surgery
关键词
儿科
经外周静脉穿刺中心静脉导管
血栓
诊断
彩色多普勒超声
pediatrics
peripherally inserted central venous catheter
thrombus
diagnosis
color Doppler ultrasound
