2018 6 40 3 255 D - 1 1 1 1 1 1 2 1. 246000 2. 2015-01~ 2017-11 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:10.16343/j.cnki.issn.2095-512x.2018.03.012 2095-512X201803-0255-05 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 246000 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 47 2018-01-28 2018-05-17 1970- E-mail852129381@ qq.com 010050
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 1.2 1.2.1 Philps 1~ 3 DVT IE33 TOSHIBA SSH-880CV 7.5MHz 4~ 6 DVT DVT 1.2.2 4mL 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 2 1.1 1 P<0.05 2015-01 ~ 2017-11 DVT 2 236 143 93 33 ~ 73 53.69±14.18 2.1 236 DVT 47 DVT 189 DVT
2018 6 40 3 257 DVT40 DVT 183 DVT38 DVT 175 Tab.1 1 DVT46 DVT 183 1 D- DVT Analysis of DVT diagnosis by color Doppler ultrasound and plasma D-dimer alone and in combination + - + - + - + 40 6 46 + 38 14 52 + 46 6 52-7 183 190-9 175 184-1 183 184 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 94.49%223 /236 86.96%40 /46 96.32%183 /190 80.85%38 /47 92.59%175 /189 90.25%213 /236 %38 /52 %175 /184 97.87%46 /47 96.83%183 /189 97.03%229 /236 88.46%46 /52 99.46%183 /184 χ 2 6.956 5.160 9.706 5.147 6.284 P 0.031 0.076 0.008 0.076 0.043 2.3 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
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