摘要
目的观察血管超声在脑梗死偏瘫患者下肢深静脉血栓形成(DVT)诊断中的应用效果。方法选取2017年12月至2018年11月聊城市人民医院收治的疑似下肢DVT的脑梗死偏瘫患者103例,入选者均接受双功能彩色多普勒超声(CDU)、数字减影血管造影(DSA)检查。观察治疗前、后患肢血管的特征改变及健肢血管特征,以DSA检查结果作为"金标准",评估CDU检查准确率、特异度、敏感度。结果与健肢比较,治疗前患肢病变处血管内径较大,血流速度较低,血管内膜异常、瓣膜功能不全、管内回声异常发生率较高,差异有统计学意义(P<0.05);与治疗前相比,治疗后患肢病变处血管内径较小,血流速度较快,血管内膜异常、瓣膜功能不全、管内回声异常发生率较低,差异有统计学意义(P<0.05)。103例疑似DVT患者中,经DSA检查诊断阳性、阴性分别为88、15例;CDU诊断阳性、阴性分别为87、16例;CDU诊断的准确率、特异度、敏感度分别为97.09%、93.33%、97.73%;对CDU、DSA间检验结果行Kappa分析,Kappa值为0.886,表明CDU可达到与DSA诊断一致的效果。结论CDU用于脑梗死偏瘫患者下肢DVT检查中准确率较高,利于为下肢DVT的早期诊治、治疗效果评估提供指导。
Objective To observe the effect of vascular ultrasound in the diagnosis of deep venous thrombosis (DVT) in lower limbs of hemiplegic patients with cerebral ischemic stroke. Methods A total of 103 patients with hemiplegia caused by cerebral ischemic stroke who were suspected to be with lower extremity DVT admitted to Liaocheng People’s Hospital from December 2017 to November 2018 were selected. All the selected patients received dual functional color doppler ultrasound (CDU) and digital subtraction angiography (DSA) examinations. The changes of vascular characteristics of the affected limb before and after treatment and the vascular characteristics of the healthy limb were observed. DSA examination results were taken as the "gold standard" to evaluate the CDU examination accuracy, specificity and sensitivity. Results Compared with healthy limbs, the incidences of vascular endodiameter, blood flow velocity, endometrial abnormality, valve insufficiency and intraluminal echo abnormality were higher in the affected limb lesions before treatment, and the difference was statistically significant (P<0.05). The incidences of smaller vascular diameter and faster blood flow, endometrial abnormality, valve insufficiency and intraluminal echo abnormality in the affected limb lesions after treatment were lower than the preoperative incidence, and the difference was statistically significant (P<0.05). Among the 103 patients suspected to be with DVT, 88 cases were diagnosed positive and 15 cases were diagnosed negative by DSA;87 cases were diagnosed positive and 16 cases were diagnosed negative by CDU. The diagnostic accuracy, specificity and sensitivity of CDU were 97.09%, 93.33% and 97.73%, respectively. Kappa analysis was performed to compare the test results of CDU and DSA, and the Kappa value was 0.886, indicating that the diagnosis effect of CDU was consistent with DSA. Conclusions CDU has a high accuracy in the examination of lower limb DVT in hemiplegic patients with cerebral ischemic stroke, which can provide guidance
作者
张栋
Zhang Dong(Department of Ultrasonography, Liaocheng People’s Hospital, Liaocheng 252000, China)
出处
《中国实用医刊》
2019年第15期67-69,共3页
Chinese Journal of Practical Medicine
关键词
脑梗死
偏瘫
下肢深静脉血栓形成
血管超声
诊断准确率
Cerebral infarction
Hemiplegia
Deep venous thrombosis of lower extremity
Vascular ultrasound
Diagnostic accuracy
