摘要
目的比较临床症状和多普勒超声(CDFI)诊断深静脉血栓(DVT)的价值。方法2002年7月至2005年1月在上海市第六人民医院行人工全膝关节置换术(TKA)的71例低风险患者80膝,于术后1周内观察临床症状,并行静脉造影和CDFI检查。统计分析临床症状和CDFI对诊断术后DVT的敏感度和特异度。结果术后1周静脉造影确诊的DVT发生率为62．0％(44／71例)。临床症状的诊断价值:术后1周DVT的发生率为56．3％(40／71例),其敏感度为50．0％,特异度为33．3％,且临床症状与DVT的发生率无关(P= 0．322)。CDFI的诊断价值:近端血栓发生率为18．3％(13／71例),其对于近端血栓诊断的敏感度为92．3％、特异度为98．3％;远端血栓发生率为26．8％(19／71例),其对于远端血栓诊断的敏感度为54．8％,特异度为95．0％。结论临床症状诊断DVT的敏感度和特异度较低,无法指导临床诊断;而CDFI对近端血栓的敏感度和特异度较高,适合作为DVT常规筛选和诊断的方法。
Objective To compare the diagnostic value of clinical symptomatology and Doppler ultrasound in deep vein thromhosis（DVT） after total knee arthroplasty（TKA） by assessing the sensitivity and the specificity. Methods Between July 2002 and Jan 2005, 71 patients＇ 80 knees underwent Doppler ultrasound and venography 7 days after TKA in Shanghai Sixth People＇s Hospital. We analyzed the data and assessed the incidence of DVT＇ with the sensitivity and specificity of the clinical symptomatology and Doppler ultrasonogram. Results The incidence of DVT after TKA was 62. 0% chinically which were confirmed by venography. The sensitivity and specificity of clinical symptoms in the diagnosis of DVT were 50. 0% and 33.3%, respectively which those of Doppler ultrasonogram were 92. 3% and 98. 3% in proximal DVT, respectively. Furthermore with 54.8% for sensivity in distal DVT and 95.0% for the specificity. Conclusion The sensitivity and specificity of clinical symptomatology, Dopplor ultrasound with high sensitivity and specificity than clinical symptomatology especially in regard to diagnose proximal DVT; is more properly to lie the routine screening and diagnosing method of choice.
出处
《上海医学》
CAS
CSCD
北大核心
2007年第1期34-36,共3页
Shanghai Medical Journal
关键词
深静脉血栓
临床症状
多普勒超声
静脉造影
全膝关节置换术
Deep vein thrombosis
Clinical symptomatology
Doppler ultrasound
Venography
Total knee arthroplasty
