Nghiên cứu giá trị của siêu âm trong chẩn đoán huyết khối tĩnh mạch sâu chi dưới

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Tác giả: Đắc Hồng Ân Ngô, Quốc Bảo Nguyễn

Ngôn ngữ: Vie

Ký hiệu phân loại: 616.15 Diseases of blood

Thông tin xuất bản: Tạp chí Y Dược học Huế 2023

Mô tả vật lý: 170-175

Bộ sưu tập: Metadata

ID: 410593

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Tóm tắt
Chủ đề

Nghiên cứu giá trị của siêu âm trong chẩn đoán huyết khối tĩnh mạch sâu (HKTMS) chi dưới. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang trên 20 bệnh nhân được chẩn đoán HKTMS chi dưới, được siêu âm và can thiệp nội mạch tại Bệnh viện Trường Đại học Y - Dược Huế từ 1/2021 - 8/2022. Kết quả: Tuổi trung bình của nhóm nghiên cứu là 58,63 ± 16,9 (17 - 85 tuổi). Vị trí HKTMS chủ yếu bên chân trái, chiếm đa số ở tầng đùi - khoeo. Siêu âm có độ nhạy 93,6%, độ đặc hiệu 97,6%, giá trị dự đoán dương tính 98,6%, giá trị dự đoán âm tính 89,1% và độ chính xác 95% trong chẩn đoán HKTMS chi dưới. Độ nhạy và độ đặc hiệu của siêu âm trong đánh giá giai đoạn huyết khối cấp hay mạn là 96,5% và 92%. Siêu âm có độ nhạy thấp trong khảo sát tuần hoàn bàng hệ và hội chứng May-Thurner. Kết luận: Siêu âm có giá trị cao trong chẩn đoán huyết khối tĩnh mạch sâu, độ nhạy thấp trong khảo sát tuần hoàn bàng hệ và hội chứng May-Thurner. , Tóm tắt tiếng anh, To determine the diagnostic value of ultrasound in lower extremity deep vein thrombosis (LEDVT). Methods: Data of 20 patients diagnosed with LEDVT and underwent endovascular treatment at Hue University of Medicine and Pharmacy hospital from 01/2021 - 08/2022 were analyzed. Ultrasound findings were documented and correlated with venography. All patients were initialized with anticoagulation upon the diagnosis of LEDVT. Endovascular treatment included diagnostic venography, inferior vena cava filter insertion, intraclot thrombolysis, manual thromboaspiration with or without venoplasty and stenting. Results: The mean age was 58.63 ± 16.9 (range, 17 - 85 age). The major risk factors were trauma, surgery, and a history of DVT. LEDVT was found prominently in the left leg and at the femoropopliteal level. Ultrasound had a sensitivity of 93.6%, a specificity of 97.6%, a positive predictive value of 98.6%, a negative predictive value of 89.1% and accuracy of 95% in the diagnosis of LEDVT. The sensitivity and specificity of ultrasound in differentiating between chronic and acute thrombus were 96.5% and 92%. Ultrasound had low sensitivity in evaluating collaterals and venous outflow obstruction (May-Thurner syndrome). Conclusion: Ultrasound has a high diagnostic value and remains the first line imaging modality in the investigation of LEDVT.

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