Garcia N D, Morasch M D, Ebaugh J L, Shah S, Blackburn D, Astleford P, Matsumura J S, Yao J S, Pearce W H
Division of Vascular Surgery, Northwestern University, Chicago, Illinois 60611, USA.
J Vasc Surg. 2001 Nov;34(5):792-7. doi: 10.1067/mva.2001.118805.
The purpose of this study was to determine the necessity of bilateral lower-extremity venous duplex ultrasound scanning in patients with unilateral symptoms of deep vein thrombosis (DVT).
A retrospective review of 1080 bilateral venous duplex scans was performed. Patients were randomly selected from a total of 7922 studied between May 1998 and May 2000. Data on patient age, sex, comorbidity, and the reason for ultrasound scan were compiled. Forty percent (435/1080) of patients presented with unilateral symptoms of lower-extremity DVT. This group was further analyzed according to their status as inpatients or outpatients.
DVT was diagnosed in 26.9% (117/435) of the patients. Of the inpatients found to have DVT, the thrombus was confined to the symptomatic leg in 23.8% (38/159), thrombus was present just in the asymptomatic leg in 8/159 (5.0%), and thrombus was found in both legs in 8/159 (5.0%). In the outpatient group, thrombus was confined to the symptomatic leg in 21.0% (58/276) and found in both legs in 1.8% (5/276). None of the 276 outpatients had DVT isolated in the asymptomatic leg.
Routine bilateral lower-extremity venous duplex studies are not necessary in outpatients presenting with unilateral symptoms. In many outpatients, a single-limb study will suffice. If a patient is found to have a DVT on the symptomatic side, then we believe that a bilateral study is indicated. We do believe that routine bilateral scanning of inpatients remains justified. This algorithm may save technician time and increase vascular laboratory efficiency.
本研究的目的是确定在有单侧下肢深静脉血栓形成（DVT）症状的患者中进行双侧下肢静脉双重超声扫描的必要性。
对1080例双侧静脉双重扫描进行回顾性分析。患者从1998年5月至2000年5月期间共研究的7922例中随机选取。收集患者年龄、性别、合并症以及超声扫描原因的数据。40%（435/1080）的患者表现为单侧下肢DVT症状。该组患者进一步根据其住院或门诊状态进行分析。
26.9%（117/435）的患者被诊断为DVT。在被发现患有DVT的住院患者中，血栓局限于有症状的腿部的占23.8%（38/159），仅在无症状腿部存在血栓的占8/159（5.0%），双腿均发现血栓的占8/159（5.0%）。在门诊患者组中，血栓局限于有症状腿部的占21.0%（58/276），双腿均发现血栓的占1.8%（5/276）。276例门诊患者中无一例在无症状腿部单独发现DVT。
对于有单侧症状的门诊患者，常规双侧下肢静脉双重检查没有必要。在许多门诊患者中，单肢检查就足够了。如果发现患者有症状一侧患有DVT，那么我们认为需要进行双侧检查。我们确实认为对住院患者进行常规双侧扫描仍然是合理的。这种方案可以节省技术人员的时间并提高血管实验室的效率。
