Pfeifer K J
Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Orthopade. 1993 Apr;22(2):124-7.
The bedside diagnosis of deep venous thrombosis is not accurate enough to implement invasive therapy, e.g., systemic administration of thrombolytic agents, so the diagnosis must be established by independent diagnostic means. The most useful diagnostic tests available include Doppler ultrasound, duplex sonography, color duplex sonography, and contrast venography. The common femoral vein and popliteal vein can be examined easily with a Doppler ultrasound probe. Reduced blood flow due to major venous thrombosis proximal or distal to the probe, qualitative blood flow and flow direction are all detectable. Duplex sonography allows imaging of thrombosed areas and provides structural information on thrombi and the attachment sites to the endothelium. These noninvasive methods are insensitive to thrombosis in the lower leg. Color duplex sonography in addition provides diagnostic information about the quantitative blood flow and simplifies the diagnostic procedure. If these tests are not available or the findings are equivocal, contrast venography is performed, which is the most sensitive and reliable test for confirming or excluding deep venous thrombosis.
深静脉血栓形成的床旁诊断准确性不足以实施侵入性治疗，例如全身应用溶栓药物，因此必须通过独立的诊断方法来确立诊断。现有的最有用的诊断检查包括多普勒超声、双功超声、彩色双功超声和静脉造影。使用多普勒超声探头可以轻松检查股总静脉和腘静脉。探头近端或远端的主要静脉血栓形成导致的血流减少、血流性质和血流方向均可检测到。双功超声可以对血栓形成区域进行成像，并提供血栓及其与内皮附着部位的结构信息。这些非侵入性方法对小腿部血栓形成不敏感。彩色双功超声还可提供有关定量血流的诊断信息，并简化诊断程序。如果无法进行这些检查或检查结果不明确，则进行静脉造影，这是确认或排除深静脉血栓形成的最敏感和可靠的检查。
