床旁便携超声筛查“4·20”芦山地震伤员外周静脉血栓的价值
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摘要
目的探讨床旁便携式超声筛查"4·20"芦山地震伤员外周静脉血栓的价值。方法对2013年4月20日-5月5日住院的321例地震伤员中203例骨折伤员行床旁外周静脉彩色多普勒超声筛查的情况进行回顾分析。结果检出静脉血栓63例(31.03%)82个部位,其中髂静脉血栓1例,下肢静脉血栓53例共71个肢体,上肢静脉血栓9例共10个肢体。外伤后首次检查到患者血栓的时间为2~15 d,平均(6.1±3.8)d;入院时查见血栓45例,入院后血栓范围增加19例,血栓范围减少26例;新发生血栓18例。无患者因肺栓塞死亡。结论地震伤员外周静脉血栓发生率高,以小腿肌间静脉为主;外伤后发生血栓时间短;床旁便携式超声是观察外周静脉血栓的首选检查方法。
Objective To explore the value of portable ultrasound in assessing peripheral vein thrombosis of the injured in Lushan earthquake on April 20,2013.Methods From April 20 th to May 5th in 2013,321 earthquake victims were admitted into our hospital,and 203 fractured patients of them accepted peripheral venous two-dimensional and color doppler ultrasound examination beside the bed every three days.Results Sixty-three patients(82 locations)suffered from venous thrombosis in the 203 earthquake victims,and the rate was 31.03%(63/203).Among them,one suffered from iliac vein thrombosis;53 patients(71 limbs) were attacked by lower limb venous thrombosis;9 patients(10limbs) suffered from upper limb venous thrombosis.The time was from 2 to 15 days after trauma when the victims were diagnosed to have thrombus at the first time,averaging(6.1±3.8) days.On admission day,45 victims were diagnosed with peripheral vein thrombosis.Among them,19 patients increased the scope of thrombus after admission in hospital,while 26 victims reduced the scope.Eighteen victims suffered from newly developed peripheral venous thrombus after admission in hospital.None of the hospitalized patients died of pulmonary embolism.Conclusions The victims injured in the earthquake have a high incidence of peripheral vein thrombosis,and the calf is the main site of the disease.After trauma,peripheral venous thrombosis occurs within a short time.Bedside portable ultrasound is the first choice for peripheral vein thrombosis in the earthquake victims.
Objective To explore the value of portable ultrasound in assessing peripheral vein thrombosis of the injured in Lushan earthquake on April 20,2013.Methods From April 20 th to May 5th in 2013,321 earthquake victims were admitted into our hospital,and 203 fractured patients of them accepted peripheral venous two-dimensional and color doppler ultrasound examination beside the bed every three days.Results Sixty-three patients(82 locations)suffered from venous thrombosis in the 203 earthquake victims,and the rate was 31.03%(63/203).Among them,one suffered from iliac vein thrombosis;53 patients(71 limbs) were attacked by lower limb venous thrombosis;9 patients(10limbs) suffered from upper limb venous thrombosis.The time was from 2 to 15 days after trauma when the victims were diagnosed to have thrombus at the first time,averaging(6.1±3.8) days.On admission day,45 victims were diagnosed with peripheral vein thrombosis.Among them,19 patients increased the scope of thrombus after admission in hospital,while 26 victims reduced the scope.Eighteen victims suffered from newly developed peripheral venous thrombus after admission in hospital.None of the hospitalized patients died of pulmonary embolism.Conclusions The victims injured in the earthquake have a high incidence of peripheral vein thrombosis,and the calf is the main site of the disease.After trauma,peripheral venous thrombosis occurs within a short time.Bedside portable ultrasound is the first choice for peripheral vein thrombosis in the earthquake victims.
引文
1 吕玲环,王星,王磌,等.下肢深静脉血栓彩色多普勒超声显像的探讨[J].中国超声医学杂志,2001,17(8):44-46.
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3 王志生,王慧丽,高照宾,等.696例创伤后早期深静脉血栓的流行病学特征[J].创伤外科杂志,2009,11(1):83-85.
4 Terakami T,Ohba N,Morishita E.Deep vein thrombosis in Noto Peninsula earthquake victims[J].Rinsho Byori,2009,57(5):411-416.
5 Shibata M,Hanzawa K,Ueda S,et al.Deep venous thrombosis among disaster shelter inhabitants following the March 2011earthquake and tsunami in Japan:a descriptive study[J].Phlebology,2014,29(4):257-266.
6 Ueda S,Hanzawa K,Shibata M,et al.High prevalence of deep vein thrombosis in tsunami-flooded shelters established after the great East-Japan earthquake[J].Tohoku J Exp Med,2012,227(3):199-202.
7于蕾,宋奕宁,张珊珊,等.彩色多普勒超声探测小腿肌间静脉扩张与单纯肌间静脉血栓的关系[J].临床超声医学杂志,2009,11(6):380-382.
8 张宇,薛恩生,林礼务,等.围手术期小腿深静脉血栓的早期超声诊断及预后[J].临床超声医学杂志,2010,12(3):162-164.
9 Shorter M,Macias DJ.Portable handheld ultrasound in austere environments:use in the Haiti disaster[J].Prehosp Disaster Med,2012,27(2):172-177.
10 Hirsh J,Lee AY.How we diagnose and treat deep vein thrombosis[J].Blood,2002,99(9):3102-3110.
11 韩秋,刘彦丽,李广霞,等.彩色多普勒超声检查下肢深静脉血栓的诊断意义[J].中外医疗,2010,29(25):171-172.
12 张晓蓉,何文,唐华,等.小腿静脉血栓的影像学诊断[J].中国医学影像技术,2004,20(7):1064-1067.
2 郝淑琴.下肢静脉血栓形成60例彩色多普勒超声诊断分析[J].中国实用医药,2011,6(14):124-125.
3 王志生,王慧丽,高照宾,等.696例创伤后早期深静脉血栓的流行病学特征[J].创伤外科杂志,2009,11(1):83-85.
4 Terakami T,Ohba N,Morishita E.Deep vein thrombosis in Noto Peninsula earthquake victims[J].Rinsho Byori,2009,57(5):411-416.
5 Shibata M,Hanzawa K,Ueda S,et al.Deep venous thrombosis among disaster shelter inhabitants following the March 2011earthquake and tsunami in Japan:a descriptive study[J].Phlebology,2014,29(4):257-266.
6 Ueda S,Hanzawa K,Shibata M,et al.High prevalence of deep vein thrombosis in tsunami-flooded shelters established after the great East-Japan earthquake[J].Tohoku J Exp Med,2012,227(3):199-202.
7于蕾,宋奕宁,张珊珊,等.彩色多普勒超声探测小腿肌间静脉扩张与单纯肌间静脉血栓的关系[J].临床超声医学杂志,2009,11(6):380-382.
8 张宇,薛恩生,林礼务,等.围手术期小腿深静脉血栓的早期超声诊断及预后[J].临床超声医学杂志,2010,12(3):162-164.
9 Shorter M,Macias DJ.Portable handheld ultrasound in austere environments:use in the Haiti disaster[J].Prehosp Disaster Med,2012,27(2):172-177.
10 Hirsh J,Lee AY.How we diagnose and treat deep vein thrombosis[J].Blood,2002,99(9):3102-3110.
11 韩秋,刘彦丽,李广霞,等.彩色多普勒超声检查下肢深静脉血栓的诊断意义[J].中外医疗,2010,29(25):171-172.
12 张晓蓉,何文,唐华,等.小腿静脉血栓的影像学诊断[J].中国医学影像技术,2004,20(7):1064-1067.
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