目的探讨彩色多普勒超声在患者血栓前状态检查中的运用价值。方法2011年10月至2012年11月昆明医科大学第一附属医院血管外科运用彩色多普勒超声检查发现血栓前状态患者,共计201例,男95例,女106例;年龄15—78岁,平均52岁。结合彩超影像对比和相关文献复习,将上述患者进行分组干预观察。结果治疗前“暴风雪”征段血管内血流峰值分别为股静脉(0.16±0.03)m/s,胴静脉(0.14±0.03)m/s,肌间静脉(0.13±0.02)m/s,治疗后股静脉(0.19±0.03)m/s;胭静脉(0.17±0.03)m/s;肌间静脉(0.15±0.01)m/s,152例血栓前状态患者治疗后超声检测血流峰值增高,管腔内滞缓流动显示减轻或消失,提示血流减慢消失、血液高凝状态明显改善或消失,患者自觉肢体酸胀明显好转;49例未接受药物干预者中,12例为重度全管腔型“暴风雪”征患者,2周内有8例发生“暴风雪”征段血管内血栓形成,其血栓发生率为66.7%。结论彩色多普勒超声检查可有效的发现和评估血栓前状态并可指导对血栓形成的有效干预。
Objective To explore the clinical value of color Doppler ultrasound in patients with prethrombotic state (PTS). Methods From October 2011 to November 2012, a total of 201 patients were diagnosed with PTS. There were 95 males and 106 females with an average age of 52 years (range: 15 - 78). They were divided into intervention and observation groups on the basis of drug intervention. And the relevant literatures were reviewed and the images of color Doppler ultrasound before and after treatment compared. Results Before treatment, blood flow peak rates of common femoral, popliteal and calf intermuscular veins were (0.16 ± 0.03 ), (0.14 ± 0.03 ) and (0.13 ± 0.02) m/s ; after treatment, (0.19 ±0.03) , (0.17 ±0.03) and (0.15 ±0.01 ) m/s respectively. The peak flow increased and sluggish flow decreased or disappeared in 152 PS patients. It indicated a relief or an obvious resolution of hypercoagulable state. And the symptom of lower extremity soreness was greatly relieved. Among 49 patients without drug intervention, severe full-lumen storm floating occurred in 12 cases. And 8 of them suffered deep vein thrombosis within 2 weeks. The incidence of thrombus was 66.7%. Conclusion Color Doppler ultrasound may detect and assess PTS effectively so as to guide effective interventions.