摘要
目的探讨彩色多普勒血流显像评价老年骨创伤患者围术期及随访期下肢深静脉血栓的价值。方法回顾性分析2014年1月至2015年7月在我院手术治疗的45例老年骨创伤伴下肢深静脉血栓形成的患者，观察围术期及术后1～6个月下肢深静脉血栓形成时间、位置、阻塞程度及再通的彩色多普勒血流显像表现。结果45例下肢深静脉血栓术前7d内发生率为13．3％（6／45）；术后I～14d，平均（6．03±2．57）d，发生率为66．7％（30／45），其中术后3d内发生率为15．6％（7／45），最早血栓可于术后Id检出；出院后（2个月内）发生率为20．0％（9／45）。血栓以远段静脉多见，占82．2％（37／45），其中孤立性小腿肌间静脉血栓发生率最高为64．4％（29／45）；45例患者随访时间i～6个月，平均（3．42iI．42）个月，静脉管腔完全再通率达53．3％（24／45）。结论彩色多普勒血流显像能够早期准确检出无症状下肢深静脉血栓，便于床旁检查及动态监测抗凝治疗过程中有无新发或再发血栓、血管再通情况，为老年骨创伤患者下肢深静脉血栓临床早期诊断、抗凝疗效评价及规范治疗提供可靠依据。
Objective To explore the estimated value of color Doppler flow imaging （CDFI） in detecting the incidence of lower limb deep vein thrombosis （DVT） during perioperative period and follow-up phase in the elderly patients with orthopedic trauma. Methods Forty-five elderly patients undergoing orthopedic surgery in our hospital from January 2014 to July 2015 were retrospectively studied. They were diagnosed with lower limb DVT by CDFI. The CDFI manifestations on both thrombus formation time and location, the embolism degree and vessel recanalization were observed during perioperative period and 1 to 6 months after surgery. Results Among the 45 patients receiving ultrasonography screening, DVT developed in 6 （13.3%） patients within 7 days before surgery; DVT developed in 30 （66.7%） patients within 1-14 days [（6.03±2.57） days at average] postoperatively; and DVT developed in 7 （15.6%） patients within 3 days after surgery, with the earliest thrombosis detected at 1 day after surgery. DVT developed in 20.0 % （9/45） patients within 2 months after discharge. Thrombus was more common in distal venous, which accounted for 82.2% （37/45）. The highest occurrence rate of DVT was 64.4%（29/45） in calf muscular veins. And 1 to 6 months （3.42±1.42）months follow-up study in 45 patients after surgery showed that the rate of vessel recanalization was 53.3%（24/45）. Conclusions CDFI can earlier and effectively detect asymptomatic DVT, and is convenient for screening new or recurrent thrombus and vascular recanalization during bedside examination and dynamic monitoring periods. Ultrasonography provides reliable evidence for clinical early diagnosis, assessment of anticoagulate efficiency and can standard the treatment for elderly orthopedic trauma patients with low limb DVT.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2016年第11期1217-1220,共4页
Chinese Journal of Geriatrics
关键词
超声检查
创伤和损伤
骨
静脉血栓形成
Ultrasonography
Wounds and injuries
Bones
Venous thrombosis
