Diagnostic significance of ultrasonography on free-floating thrombus shedding in deep vein of lower extremity in fracture patients

doi:10.11958/20231288

Abstract

Abstract:

Objective To explore the diagnostic significance of ultrasonography on free-floating thrombus in deep vein (DV) shedding of lower extremity in fracture patients. Methods The ultrasound and clinical data were collected from 127 patients with lower extremity free-floating DV thrombosis and implantation of inferior vena cava filter (IVCF). The ultrasound data included the echo and activity of thrombus, thrombus activity, thrombus length, thrombus location, thrombus side and thrombus color Doppler imaging. Clinical data included gender, age, fracture site, thrombin time (TT), D-dimer (D-D) and fibrinogen (FIB). The Logistic regression model was used to analyze influencing factors of thrombus shedding in patients with floating DV thrombus (P<0.05). Results Patients were divided into two groups based on the presence or absence of thrombus shedding in IVCF. There were 51 patients in the thrombus shedding group and 76 patients in the non-thrombus shedding group. Thrombus was extremely low echogenicity. Thrombus activity was floating or slightly floating was independent risk factors for DV floating thrombus shedding. Patients with extremely low echogenicity of thrombus were 4.182 times higher probability of thrombus shedding than those with moderate echogenicity (95%CI: 1.209-14.468, P=0.024). Patients with slightly floating or floating thrombus had a 4.979 times higher (95%CI: 1.851-13.391, P=0.001) and 11.373 times higher probability of thrombus shedding (95%CI: 3.936-32.863, P<0.001) than those with the tip of thrombus floating, respectively. Conclusion Ultrasonic indicators such as thrombus echo and thrombus activity have certain significance in the diagnosis of DV free-floating thrombus shedding in patients with traumatic fracture.

Key words: venous thrombosis, ultrasonography, risk factors, free-floating thrombus, shedding

CLC Number:

R445.14

Figures/Tables 3

References 13

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组别			n	年龄/岁				男性		血栓长度/cm			血栓位置
组别			n	年龄/岁				男性		血栓长度/cm			CFV			SFV				POPV				PTV		PEV
未脱落组			76	61.68±9.96				39（51.3）		6.27±1.36			26（34.2）			12（15.8）				35（46.1）				3（3.9）		0（0）
脱落组			51	60.24±8.26				28（54.9）		6.80±1.71			17（33.3）			6（11.8）				25（49.0）				0（0）		3（5.9）
t、χ²或Z				0.859				0.157		1.851			6.896
组别	血栓回声								血栓侧别						活动程度							CDFI
组别	中等				低		极低		左侧			右侧			头端漂浮			轻微漂浮			漂浮	无			绕行
未脱落组	16（21.1）				42（55.3）		18（23.7）		39（51.3）			37（48.7）			54（71.1）			14（18.4）			8（10.5）	13（17.1）			63（82.9）
脱落组	6（11.8）				17（33.3）		28（54.9）		28（54.9）			23（45.1）			12（23.5）			16（31.4）			23（45.1）	7（13.7）			44（86.3）
t、χ²或Z	12.891^＊＊								0.157						30.374^＊＊							0.263
组别		FIB/（g/L）				D-D/（μg/L）					TT/s			骨折部位
组别		FIB/（g/L）				D-D/（μg/L）					TT/s			股骨			骨盆		胫腓骨				膝				足踝
未脱落组		4.85（3.95，4.84）				900（600，1 200）					12.27±1.40			29（38.2）			15（19.7）		10（13.2）				18（23.7）				4（5.3）
脱落组		5.64（4.02，7.42）				900（600，1 400）					12.53±1.32			17（33.3）			11（21.6）		7（13.7）				13（25.5）				3（5.9）
t、χ²或Z		1.323				0.266					1.025			0.316

组别			n	年龄/岁				男性		血栓长度/cm			血栓位置
组别			n	年龄/岁				男性		血栓长度/cm			CFV			SFV				POPV				PTV		PEV
未脱落组			76	61.68±9.96				39（51.3）		6.27±1.36			26（34.2）			12（15.8）				35（46.1）				3（3.9）		0（0）
脱落组			51	60.24±8.26				28（54.9）		6.80±1.71			17（33.3）			6（11.8）				25（49.0）				0（0）		3（5.9）
t、χ²或Z				0.859				0.157		1.851			6.896
组别	血栓回声								血栓侧别						活动程度							CDFI
组别	中等				低		极低		左侧			右侧			头端漂浮			轻微漂浮			漂浮	无			绕行
未脱落组	16（21.1）				42（55.3）		18（23.7）		39（51.3）			37（48.7）			54（71.1）			14（18.4）			8（10.5）	13（17.1）			63（82.9）
脱落组	6（11.8）				17（33.3）		28（54.9）		28（54.9）			23（45.1）			12（23.5）			16（31.4）			23（45.1）	7（13.7）			44（86.3）
t、χ²或Z	12.891^＊＊								0.157						30.374^＊＊							0.263
组别		FIB/（g/L）				D-D/（μg/L）					TT/s			骨折部位
组别		FIB/（g/L）				D-D/（μg/L）					TT/s			股骨			骨盆		胫腓骨				膝				足踝
未脱落组		4.85（3.95，4.84）				900（600，1 200）					12.27±1.40			29（38.2）			15（19.7）		10（13.2）				18（23.7）				4（5.3）
脱落组		5.64（4.02，7.42）				900（600，1 400）					12.53±1.32			17（33.3）			11（21.6）		7（13.7）				13（25.5）				3（5.9）
t、χ²或Z		1.323				0.266					1.025			0.316

变量	β	SE	Wald χ²	P	OR（95%CI）
血栓回声			6.889	0.032
低回声	0.438	0.625	0.491	0.483	1.549（0.455~5.273）
极低回声	1.431	0.633	5.105	0.024	4.182（1.209~14.468）
活动程度			22.386	0.001
轻微漂浮	1.605	0.505	10.114	0.001	4.979（1.851~13.391）
漂浮	2.431	0.541	20.169	<0.001	11.373（3.936~32.863）
常数项	-2.205	0.616	12.815	<0.001	0.110

变量	β	SE	Wald χ²	P	OR（95%CI）
血栓回声			6.889	0.032
低回声	0.438	0.625	0.491	0.483	1.549（0.455~5.273）
极低回声	1.431	0.633	5.105	0.024	4.182（1.209~14.468）
活动程度			22.386	0.001
轻微漂浮	1.605	0.505	10.114	0.001	4.979（1.851~13.391）
漂浮	2.431	0.541	20.169	<0.001	11.373（3.936~32.863）
常数项	-2.205	0.616	12.815	<0.001	0.110

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