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目的与X线顺行静脉造影结果进行对比,探讨彩色多普勒超声(彩超)在小腿穿静脉检查中的作用价值。方法选取2014年1月—2016年3月临床诊断为大隐静脉曲张的53例患者(60条下肢),行彩超及X线顺行静脉造影检查,两者结果进行比较,并经手术证实。结果彩超与X线顺行静脉造影分别诊断小腿穿静脉瓣膜功能不全下肢47条和50条,两种检查方法比较差异无统计学意义(χ2=0.800,P=0.371);彩超共检出穿静脉78条,每条下肢检出穿静脉1~4条,其中穿静脉内径在2~5 mm者共66条,占84.6%,除2条<2 mm的穿静脉外,余均探及反流;其中距足底10~32 mm范围者(即足靴区)共73条,占93.6%;52条大隐静脉曲张下肢进行了大隐静脉高位结扎激光消融或+穿静脉离断术,与手术结果比较,彩超诊断穿静脉瓣膜功能不全下肢真阳性37条,假阳性2条,真阴性10条,假阴性3条,彩超诊断灵敏度为92.5%(37/40),特异度为83.3%(10/12),准确率为90.4%(47/52)。结论彩超可精确定位穿静脉,测量内径及观察反流程度,诊断穿静脉瓣膜功能不全敏感性及准确性高,安全、简便、经济,适于术前、术中诊断及定位。
Objective To compare the results of X-ray venography and venous angiography to explore the value of color Doppler ultrasonography in the examination of calf veins. Methods Fifty-three patients (60 lower extremities) clinically diagnosed as saphenous varicose veins from January 2014 to March 2016 underwent color doppler ultrasonography and X-ray venography. The results were compared and confirmed by surgery. Results The color Doppler ultrasound and X-ray plain radiography were used to diagnose 47 and 50 lower limbs with venous insufficiency. There was no significant difference between the two methods (χ2 = 0.800, P = 0.371) 78 were detected in each lower limb through the veins 1 to 4, of which the diameter of the vein in the 2 ~ 5 mm were a total of 66, accounting for 84.6%, except for 2 <2 mm through the vein, the remaining exploration and reflux Of which 73 feet (93.6%) were located in the range of 10 ~ 32 mm from the sole of the foot, and 52 cases of saphenous vein of lower limbs underwent laser ablation of the great saphenous vein or + The results of color Doppler ultrasonography showed that there were 37 true positives, 2 false positives, 3 true negatives, and 3 false negatives. The diagnostic sensitivity of color Doppler ultrasound was 92.5% (37/40) and the specificity was 83.3% 10/12), the accuracy rate was 90.4% (47/52). Conclusions Color Doppler ultrasonography can precisely locate the vein, measure the diameter and observe the degree of reflux. It is safe, simple and economical to diagnose the sensitivity and accuracy of perforating venous insufficiency. It is suitable for preoperative and intraoperative diagnosis and localization.