摘要目的 比较彩色多普勒超声与静脉造影在骨盆、髋臼骨折后深静脉血栓形成(DVT)诊断中的准确性. 方法 回顾性分析2005年1月至2009年2月期间收治的73例骨盆或髋臼骨折患者资料,男54例,女19例；平均年龄为42.7岁(17 ～67岁).所有患者均通过彩色多普勒超声和静脉造影检查DVT. 结果 73例患者DVT的检查结果:彩色多普勒超声阳性37例,阴性36例；静脉造影阳性48例,阴性25例.静脉造影阳性的48例患者中,彩色多普勒超声阳性34例,阴性14例；静脉造影阴性的25例患者中,彩色多普勒超声阳性3例,阴性22例,彩色多普勒超声与静脉造影在诊断DVT方面差异无统计学意义(x2=3.407,P =0.065).以静脉造影作为诊断DVT的标准,彩色多普勒超声的敏感性为70.8％,特异性为88.0％,阳性预测值为91.9％,阴性预测值为61.1％. 结论 彩色多普勒超声可以作为骨盆、髋臼骨折后DVT的有效筛查方法.对彩色多普勒超声检查结果不确切及结果阴性而临床高度怀疑DVT的患者,可进一步行静脉造影检查.

abstractsObjective To compare the accuracy between colour Doppler sonography and venography in diagnosis of deep venous thrombosis (DVT) after pelvic and acetabular fractures. Methods We reviewed the 73 patients with pelvic or acetabular fractures who had been treated in our department from January 2005 through February 2009.They were 54 men and 19 women,aged from 17 to 67 years (average,42.7 years).Colour Doppler sonography and venography were performed to detect DVT in all cases. Results Colour Doppler sonography revealed 37 positive and 36 negative cases,while venography revealed 48 positive and 25 negative cases.Of the 48 cases of venography positive,34 were positive and 14 negative by colour Doppler sonography; of the 25 cases of venography negative,3 were positive and 22 negative by colour Doppler sonography.The difference in diagnosing DVT between colour Doppler sonography and venography was not significant statistically (x2 =3.407,P =0.065).With venography as reference,ultrasonographic results demonstrated a diagnostic sensitivity of 70.8％,a specificity of 88.0％,a positive predictive value of 91.9％ and a negative predictive value of 61.1％. Conclusions Colour Doppler sonography is an effective screening test in the diagnosis of DVT after pelvic and acetabular fractures.Venography can be used when ultrasonographic results are ambiguous and in clinically evident cases with negative ultrasonographic results.