XIE Hong-juan ZHANG Shu-jun XIA Qun et al.

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1 D ~ DVT 236 D- DVT DVT 236 DVT 47 DVT 175 DVT 40 DVT 175 DVT 38 DVT 156 DVT 46 DVT 175 P<0.05 P>0.05 D- d- R543.6 A DOI: /j.cnki.issn x X CLINICAL SIGNIFICANCE OF THE COLOR DOPPLER ULTRASOUND COMBINED WITH THE DETECTION OF THE LEVEL OF D-DIMER IN THE DIAGNOSIS OF EARLY DEEP VENOUS THROMBOSIS OF THE LOWER EXTREMITIES XIE Hong-juanZHANG Shu-junXIA Qunet al. Anqing First People's Hospital Anqing China AbstractObjectiveTo investigate the application value of the color Doppler ultrasound combined with the detection of the level of D-dimer in the diagnosis of early deep venous thrombosis of the lower extremities. MethodsA total of 236 suspected DVT patients in our hospital from January 2015 to November 2017 were selected.the color Doppler ultrasonography was performed and the blood samples were taken to measure the level of plasma D-dimer.The results of the deep venous angiography of the lower extremities were used as the gold standard.the results and the diagnostic value of the color Doppler ultrasound and plasma D-dimer in the combined and single diagnosis of DVT were recorded. The contents of the plasma D-dimer in patients with different stages and different types of DVT were compared.resultsthe deep venous angiography of the lower extremities confirmed that there were @ qq.com

2 256 Journal Of Inner Mongolia Medical University June 2018 Vol.40 No.3 cases diagnosed as DVT and the other 175 as non DVT among the 236 suspected patients in this group. The color Doppler ultrasonography confirmed that there were 40 cases diagnosed as DVT and the other 175 as non DVT.The plasma D-dimer confirmed that there were 38 cases diagnosed as DVT and the other 165 as non DVT.The combined diagnosis confirmed that there were 46 cases diagnosed as DVT and the other 175 as non DVT.There were significant differences in the sensitivity accuracy and negative predictive value of the single and combined diagnosis of the color Doppler ultrasound and plasma D -dimerp<0.05.there were insignificant differences in the specificity and positive predictive value a- mong the three diagnostic methodsp>0.05.conclusionthe color Doppler ultrasound combined with the detection of the level of D-dimer in the diagnosis of early deep venous thrombosis of the lower extremities can effectively improve the accuracy and sensitivity and reduce the risk of missed diagnosis and misdiagnosis.it helps to provide a reference for the clinical formulation and the adjustment of the treatment plan. Key wordscolor doppler ultrasoundd-dimerdeep venous thrombosis of the lower extremitydiagnostic value DVT Philps 1~ 3 DVT IE33 TOSHIBA SSH-880CV 7.5MHz 4~ 6 DVT DVT mL DVT <500μg /L 1.3 DVT DVT 2 7~ 9 DVT 236 DVT 1.4 SPSS 18.0 x±s 珋 t 1 LSD-t n% χ P< ~ DVT ~ ± DVT 47 DVT 189 DVT

2018 6 40 3 257 DVT40 DVT 183 DVT38 DVT 175 Tab.

47 189 236 47 189 236 47 189 236 2.2 P<0.05 P>0.05 2 Tab.2 2 D- DVT Value of color Doppler ultrasound and plasma D-dimer alone and combined in the diagnosis of DVT 85.11%40 /47 96.83%183 /189 94.

3 DVT40 DVT 183 DVT38 DVT 175 Tab.1 1 DVT46 DVT D- DVT Analysis of DVT diagnosis by color Doppler ultrasound and plasma D-dimer alone and in combination P<0.05 P> Tab.2 2 D- DVT Value of color Doppler ultrasound and plasma D-dimer alone and combined in the diagnosis of DVT 85.11%40 / %183 / %223 / %40 / %183 / %38 / %175 / %213 /236 %38 /52 %175 / %46 / %183 / %229 / %46 / %183 /184 χ P DVT 1 2 CDFI 1 3 DVT CDFI 2 DVT Fig.1 DVT sonogram CDFIno obvious blood flow signal in popliteal vein Fig.2 The DVT venography of deep vein popliteal vein anterior tibial posterior tibial vein filling defect DVT D- DVT 10~ 12 DVT D- Alhameed F 13 D- DVT 2 ~ 3d

4 258 Journal Of Inner Mongolia Medical University June 2018 Vol.40 No.3 100% 80% D- 1.P - J ~ 16 2Kleinjan A Di NM Beyerwestendorf J et al.safety and feasibility of a diagnostic algorithm combining clinical proba- bility D-dimer testing And ultrasonography for suspected upper extremity deep venous thrombosisa prospective DVT Adhikari S 17 management studyj. Ann Intern Med DVT % 3.Wells DVT J DVT 4. J DVT D J Bakhshi H Alavi-moghaddam MWu KC et al. D-dimer as an applicable test for detection of posttraumatic deep vein thrombosis in lower limb fracturej. Am J Orthop Belle Mead NJ E ~ J D- DVT 8. J D- DVT J Gornik HLSharma AM. Duplex ultrasound in the diagnosis of lower-extremity deep venous thrombosis J. Circulation J Valsalva D- D J

5 J.Anatol J Cardiol J Selcnk HSelcuk MTTemizhan Aet al. Decreased plasma concentrations of adiponectin in patients with slow coronary flow J.Heart vessels Atak RTurhan HSezgin ATet al. Effects of slow coronary artery flow on QT interval duration and dispersionj. Ann Noninvasive Electrocardiol Zhuang XPeng YBardeesi ASet al. Vessel heterogeneity of timi frame count and its relation to P - wave dispersion in patients with coronary slow J.Thorac Dis Zehir R Karabay CY Kalaycia et al.evaluation of tpe interval and tpe /QT ratio in patients with slow coronary flow 16. qrs J Dogan SM Yildirim N Gursurer M et al.p-wave duration and dispersion in patients with coronary slow flow and its relationship with thrombolysis in myocardial infarction frame count J.J Electrocardiol QT J 檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪 Alhameed FAldorzi HMShamy A et al. The saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremityj. Ann Thorac Med J J D- J J D J. 16. D J Adhikari S Zeger W Thom C et al. Isolated deep venous thrombosisimplications for2 - point compression ultrasonography of the lower extremityj. Ann Emerg Med D- 檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪 J J J. 14. Ⅱ B ⅡA 15. J J B J. J J J

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