连续2点超声波加D-二分体与全腿彩色编码多普勒超声波用于诊断疑似症状深静脉血栓症:一种随机对照试验
Enrico Bernardi1, Giuseppe Camporese, Harry R Büller
1Department of Emergency and Accident Medicine, Civic Hospital, Conegliano, Italy. enrico.bernardi@ulss7.it
JAMA
|October 9, 2008
概括
两种用于诊断下肢深静脉血栓 (DVT) 的超声波方法被发现是相当的. 这项研究将2点超声波与全腿超声波进行比较,用于管理疑似DVT的症状门诊患者.
科学领域:
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
- 临床试验 临床试验
背景情况:
- 下肢深静脉血栓 (DVT) 诊断通常涉及超声波,有两个主要策略:两点超声波和全腿超声波.
- 全腿超声波被认为对小腿静脉血栓形成更为敏感,但需要专门的专业知识和可用性.
- 没有先前的随机研究直接比较了这两种DVT诊断方法的临床有效性.
研究的目的:
- 确定2点超声波和全腿超声波在涉嫌下肢DVT的门诊患者的管理中的等价性.
- 为了比较两个超声波策略的诊断准确性和临床结果.
主要方法:
- 一项前性,多中心的随机化研究,涉及2098名症状异常患者,怀疑患有第一期DVT.
- 患者被随机分配到两点超声波 (n=1045) 或全腿超声波 (n=1053) 中.
- 主要结局是症状性静脉血栓塞栓症的3个月发病率,最初超声检查结果正常的患者,直到2007年3月进行了跟踪.
主要成果:
- 症状性静脉血栓栓塞发生在2点策略组的0.9%的患者 (7/801) 和全腿策略组的1.2% (9/763).
- 观察到的发病率差异为0.3% (95% CI,-1.4%至0.8%),符合预定义的同等性标准.
- 这两种诊断策略在疑似DVT的治疗中都显示出可比的安全性和有效性.
结论:
- 两点超声波和全腿超声波是同等的诊断策略,用于症状的门诊患者怀疑下肢DVT.
- 这些发现支持使用2点超声波作为可行的替代方案,可能提高可访问性和效率.
- 这项研究为临床实践中的DVT诊断工作提供了基于证据的指导.
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