摘要目的 探讨彩色多普勒超声检查对下肢大隐静脉曲张患者深静脉结构及血流动力学状况的诊断价值.方法 采用彩色多普勒超声观察79例96条确诊为下肢静脉曲折患者的深静脉管壁及瓣膜回声、管腔形态、反流时间、反流速度及频谱多普勒显像情况,并与静脉X-线造影对比分析,深静脉完全正常者对对照组相比.结果 彩色多普勒超声检查与造影对比,深静脉完全正常诊断准确性为98.3％,单纯深静脉瓣功能不全诊断准确性为91.7％,深静脉血栓后遗症诊断准确性为100.0％,动脉-静脉瘘诊断准确性为100.0％.60条深静脉声像图表现与正常对照组相似.对60条大隐静脉行剥离手术,术后未出现下肢肿胀,复查彩超亦未见深静脉返流现象.96条患肢均可测及不同部位、不同程度的静脉反流.其中股浅静脉瓣反流时间最长,为(5.92±1.83)s,反流速度(50.28±19.48) cm/s,小腿交通静脉反流时间最短,为(2.37±1.92)s,反流速度(27.92±17.28) cm/s.结论 彩色多普勒超声对评价下肢大隐静脉曲张患者的深静脉结构及血流状态有十分重要的临床价值.

abstractsObjective To investigate the clinical value of color Doppler ultrasound in the diagnosis of lower extremity varicosis of great saphenous vein in patients with deep vein structure and hemodynamic status.Methods 79 patients with 96 deep lower extremity varicosis were detected deep venous wall and valve echo,lumen morphology,reflux time,reflux velocity and spectrum Doppler imaging by using color Doppler ultrasound,and the results were compared with intravenous X-line angiography,while the patients with normal deep vein were selected as the control group.Results Color Doppler ultrasonography compared with angiography,the completely normal diagnostic accuracy of deep vein was 98.3％,the diagnosis accuracy of simple deep venous valve insufficiency was 91.7％,the diagnostic accuracy of sequela of deep vein thrombosis was 100.0％,the diagnosis accuracy of arteriovenous fistula was 100.0％.The sonographic appearance of 60 deep veins was similar to those of the control group.In the stripping surgery of 60 great saphenous vein,there was no postoperative lower limb swelling,review of ultrasound had no deep venous reflux phenomenon.96 suffered limbs were measured in different parts,different levels of venous reflux.The reflux time of superficial femoral vein valve was the longest,which was (5.92 ± 1.83) s,the reflux rate was (50.28 ± 19.48) cm/s,and the lower leg traffic vein reflux time was the shortest,which was (2.37 ± 1.92) s,the reflux rate was (27.92 ± 17.28) cm/s.Conclusion Color Doppler ultrasound has important clinical value for the evaluation of lower extremity varicosis of great saphenous vein in patients with deep vein structure and blood flow.