下肢静脉血流流速监测对神经外科术后患者深静脉血栓风险筛查的临床价值

目的探讨超声监测下肢静脉血流流速对筛查下肢深静脉血栓(DVT)风险的临床价值。方法选取陆军军医大学第二附属医院神经外科2020年4月—2021 年4月收治的353例术后患者，使用彩色多普勒超声对其术后第1~3天进行每日4次下肢静脉血流流速监测。根据患者住院期间是否发生深静脉血栓，分为DVT组和非DVT组，并对数据进行分析，对监测下肢血流流速筛查下肢深静脉血栓风险的价值进行分析和评估。结果DVT组与非DVT组之间的股总静脉、腘静脉和大隐静脉血流流速存在显著差异（P<0.01）。术后第1天ROC曲线分析显示腘静脉血流流速筛查神经外科患者术后血栓风险AUC最大，当截断值为13.504 cm/s时，灵敏度为99.7%，特异度为100%。结论监测下肢静脉血流流速，特别是腘静脉血流流速，对筛查神经外科患者术后深静脉血栓形成的风险具有重要临床价值。

Objective To investigate the clinical value of monitoring lower extremity venous flow velocity by ultrasound in screening the risk of lower extremity deep vein thrombosis(DVT). Methods 353 postoperative patients admitted to the Department of Neurosurgery from April 2020 to April 2021 were selected. Color Doppler ultrasound was used to monitor the lower extremity venous blood flow 4 times a day on the 1st to 3rd day after surgery. Patients were divided into DVT group and non-DVT group according to whether DVT occurred during hospitalization. Data were analyzed to analyze and evaluate the value of monitoring lower extremity blood flow velocity for screening the risk of DVT. Results There were significant differences in the flow velocity of femoral vein, popliteal vein and great saphenous vein between DVT group and non-DVT group(P<0.01). ROC curve analysis on the first postoperative day showed that the AUC of popliteal blood flow velocity screening for postoperative thrombosis risk in neurosurgery patients was the largest, and the sensitivity was 99.7% and the specificity was 100% when the cut-off value was 13.504 cm/s. Conclusion Monitoring the lower extremity venous flow velocity, especially the popliteal vein flow velocity, has important clinical value in screening the risk of DVT2 after neurosurgery.