文章摘要
张 华,刘锦林,窦 彤,路 倩,王逢茂.128排CT对股骨头置换术后下肢深静脉血栓形成的诊断价值分析[J].,2021,(24):4756-4759
128排CT对股骨头置换术后下肢深静脉血栓形成的诊断价值分析
Analysis of the Value of 128-slice CT in the Diagnosis of Deep Vein Thrombosis of Lower Limbs after Femoral Head Replacement
投稿时间:2021-03-27  修订日期:2021-04-23
DOI:10.13241/j.cnki.pmb.2021.24.032
中文关键词: 128排CT  股骨头置换术  下肢深静脉血栓形成  静脉造影  血管狭窄
英文关键词: 128-slice CT  Femoral head replacement  Deep vein thrombosis of lower limbs  Venography  Vascular stenosis
基金项目:陕西省中医管理局中医药科研项目(ZYPT017)
作者单位E-mail
张 华 陕西中医药大学附属医院关节骨科 陕西 咸阳 712000 zhak606@163.com 
刘锦林 唐都医院影像科 陕西 西安 710000  
窦 彤 陕西省人民医院影像科 陕西 西安 710000  
路 倩 陕西中医药大学附属医院关节骨科 陕西 咸阳 712000  
王逢茂 延安大学咸阳医院 CT/MR室 陕西 咸阳712000  
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中文摘要:
      摘要 目的:探讨与分析128排电子计算机断层扫描(Computed Tomography,CT)对股骨头置换术后下肢深静脉血栓形成的诊断价值。方法:2015年1月到2020年7月选择在本院诊治的股骨头置换术后疑似下肢静脉血栓形成患者78例作为研究对象,所有患者都给予128排CT检查,记录影像学特征并判断诊断价值,分析下肢深静脉血栓形成的影响因素。结果:在78例患者中,128排CT判断图像优69例,良9例,优良率为100.0 %。静脉造影判定为术后发生下肢深静脉血栓形成11例(DVT组),发生率为14.1 %,检出病变血管45支。二分类多因素Logistic回归分析显示术中出血量、手术时间、使用激素、年龄是导致股骨头置换术后下肢深静脉血栓形成的重要因素(P<0.05)。DVT组的血容量(cerebral blood volume,BV)与达峰时间(time to peak,TTP)值高于非DVT组(P<0.05),血流量(blood flow, BF)与平均通过时间(mean transit time,MTT)值低于非DVT组(P<0.05)。DVT组的血管狭窄评分低于非DVT组(P<0.05)。128排CT对股骨头置换术后下肢深静脉血栓形成的诊断敏感性与特异性为100.0 %和97.0 %。结论:术中出血量、手术时间、使用激素、年龄是导致股骨头置换术后下肢深静脉血栓形成的重要因素,128排CT能有效检出下肢深静脉血栓形成情况,具有方便、快捷、无创的特点,可为临床诊治提供可靠依据。
英文摘要:
      ABSTRACT Objective: To explore and analysis the values of 128-slice Computed Tomography (CT) in the diagnosis of deep vein thrombosis of the lower extremities after femoral head replacement. Methods: From January 2015 to July 2020, 78 cases of patients with suspected lower extremity venous thrombosis after femoral head replacement in our hospital were selected as the research objects. All patients were given 128-slice CT examination, and were to record the imaging characteristics and judged the diagnosis value, analyzed the influencing factors of deep vein thrombosis of lower extremity. Results: The 128-slice CT images were excellent in 69 cases and good in 9 cases that the excellent and good rate were 100.0 %. Accorded to venography, there were 11 cases of deep vein thrombosis of lower extremities occurred after operation(DVT group), the incidence rate were 14.1 %, and 45 cases of diseased blood vessels were detected. Binary multivariate logistic regression analysis showed that intraoperative blood loss, operation time, hormone use, and age were important factors leading to deep vein thrombosis of lower limbs after femoral head replacement(P<0.05). The values of BV and TTP in the DVT group were higher than those in the non-DVT group(P<0.05), and the values of BF and MTT were lower than those in the non-DVT group (P<0.05). The vascular stenosis score of the DVT group were lower than that of the non-DVT group (P<0.05). The sensitivity and specificity of 128-slice CT for the diagnosis of deep vein thrombosis of lower limbs after femoral head replacement were 100.0 % and 97.0 %. Conclusion: Intraoperative blood loss, operation time, hormone use, and age are important factors leading to deep vein thrombosis of lower extremities after femoral head replacement. 128-slice CT can effectively detect deep vein thrombosis of lower extremities, which are convenient, fast and non-invasive, it can provide reliable basis for clinical diagnosis and treatment.
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