摘要
目的研究彩色多普勒超声联合血液凝血功能检查对孕妇产后血栓前状态诊断及血栓发生预测的价值。方法在产前1周及产后1周内分别完成下肢彩色多普勒超声检查和凝血功能检查。两次检查中均出现两项及两项以上异常定义为血栓联合诊断阳性，两次超声检查均出现＂暴风雪＂征定义为超声诊断阳性。随访分娩后30 d内血栓形成情况。使用配对计数资料三维χ2检验比较联合诊断组及超声诊断组诊断的准确性。结果238例研究对象被纳入研究，联合诊断阳性76例，阴性162例；超声诊断阳性103例，阴性135例。至随访时间结束，联合诊断组阳性研究对象发生下肢深静脉血栓28例（36.84%）；超声诊断组阳性研究对象发生下肢深静脉血栓21例（20.39%），两组差异有统计学意义（χ2＝5.952，P＝0.015）。联合诊断组预测妊娠孕产妇发生下肢深静脉血栓发生的敏感性（90.32%）、特异性（76.81%）均高于超声诊断组（67.74%，60.39%），差异均有统计学意义（χ2值分别为4.00、22.69，P均〈0.05）。结论彩色多普勒超声联合血液凝血功能检查可诊断妊娠产妇血栓前状态，对预测下肢深静脉血栓形成具有较高的敏感性和特异性。
Objective To evaluate the value of color Doppler ultrasonography combined with coagulation test in the diagnosis of postpartum thrombosis and the prediction of thrombosis in pregnant women.MethodsColor Doppler ultrasonography and blood coagulation examination were performed at 1 weeks before and 1 weeks after delivery respectively.Two or more abnormalities in both examinations were defined as positive thrombus combined diagnosis, two ultrasound tests that showed＂snowstorm＂sign were cdefined aspositive ultrasonic diagnosis.Thrombus formation in 30d after delivery was followed up.Three-dimensional χ2 test was used to compare the sensitivity and specificity of the combined diagnosis group and the ultrasonic diagnosis group.Results238 cases were included in the study, including 76 positive cases and 162 negative cases in combined diagnosis group, 103 positive cases and 135 negative cases in ultrasonic diagnosis group.At the end of the follow-up period, there were 28 cases （36.84%） of the deep venous thrombosis of the lower extremities occurred in the combined diagnosis positive group and 21 cases （20.39%） in ultrasound diagnosis positive group.Kaplan-Meier method was used to analyze the lower extremity deep vein thrombosis of the positive subjects in the two diagnostic methods.Log Rank showed that the difference between the two groups was statistically significant （χ2=5.952, P=0.015）. The sensitivity and specificity of the combined diagnosis positive group were higher than those of ultrasound diagnosis positive group, the difference was statistically significant（90.32% vs.67.74%; 76.81% vs.60.39%） （χ2=4.00, χ2=22.69, P〈0.05）.ConclusionColor Doppler ultrasonography combined with blood coagulation function can be used to diagnose prethrombotic state in pregnant women, and have high sensitivity and specificity for predicting deep vein thrombosis of lower extremities in pregnant women.
作者
何明清
王娴
何芳
范世辉
He Mingqing;Wang Xian;He Fang;Fan Shihui(Ultrasonography Department, the First People＇s Hospital of Liangshan Yi Autonomous Prefecture, Liangshan 615000, China)
出处
《中国综合临床》
2018年第3期272-276,共5页
Clinical Medicine of China
关键词
下肢深静脉血栓
血栓前状态
彩色多普勒超声
孕产妇值
Lower extremity deep vein thrombosis
Prethrombotic state
Color Doppler ultrasonography
Maternal value
