摘要
Abstract
Objective:To investigate the diagnostic value of color Doppler ultrasonography in perioperative pulmonary embolism(PE)in patients with lower extremity fracture complicated with deep vein thrombosis(DVT).Methods:Data of 120 patients with lower extremity fracture combined with DVT admitted to Xunyang Hospital of Traditional Chinese Medicine from June 2023 to May 2024 were retrospectively analyzed,all patients underwent color Doppler ultrasonography and CT pulmonary angiography(CTPA),and were divided into a PE group and a non-PE group according to the CTPA results.The detection rate and ultrasound indexes of ultrasound images were compared between the two groups.Using CTPA results as the gold standard,the diagnostic performance of color Doppler ultrasound in patients with lower limb fractures complicated with DVT were analyzed.The diagnostic value of ultrasound indexes in the diagnosis of PE in patients with lower limb fractures complicated with DVT were analyzed.The influencing factors of perioperative PE in patients with lower limb fractures complicated with DVT were analyzed.Results:CTPA results showed that among the 120 patients with lower limb fractures complicated with DVT,53 had PE,with an incidence rate of 44.17%.The detection rates of pulmonary artery systolic blood pressure,right heart system morphology,right ventricular enlargement,right atrial enlargement,thrombus attachment of blood vessel wall,and intracardiovascular blood flow defect in the PE group were higher than those in the non-PE group,and the left and right diameter of the right atrium,the left and right diameter of the right ventricle,the upper and lower diameter of the right atrium,and the inner diameter of the main pulmonary artery were larger than those in the non-PE group,the differences were statistically significant(P<0.05).The sensitivity and specificity of color Doppler ultrasound in the diagnosis of PE were 84.91%,95.52%,and the Kappa value was 0.812.The area under the receiver operating characteristic curve of PE in patients with lower limb fractures complicated with DVT were 0.930,0.996,0.972 and 0.939,respectively.The multivariate results showed that increased systolic blood pressure of the pulmonary artery,morphological changes of the right heart system,enlargement of the right ventricle,enlargement of the right atrium,thrombus attachment of the blood vessel wall,intravascular blood flow defect,left and right diameter of the right atrium,left and right diameter of the right ventricle,upper and lower diameter of the right atrium,and inner diameter of the main pulmonary artery were the influencing factors for perioperative PE in patients with lower limb fractures complicated with DVT.Conclusion:Color Doppler ultrasound has a high diagnostic value for perioperative PE in patients with lower limb fractures complicated with DVT,and ultrasound parameters are the influencing factors for PE.关键词
下肢骨折/深静脉血栓/肺动脉栓塞/彩色多普勒超声/预测Key words
Lower limb fracture/Deep vein thrombosis/Pulmonary embolism/Color Doppler ultrasound/Forecast分类
临床医学
