CAJ | 학술논문

目的：探讨双功能超声（duplex US）对下肢动脉旁路移植术后再狭窄评估的临床价值。方法对我院63例股腘动脉旁路移植患者的80条移植血管术后行duplex US定期随访，结合管径及血流动力学参数改变进行术后再狭窄判定，分为非显著狭窄组(56条)、显著狭窄组(15条)和闭塞组(9条)，并将duplex US诊断结果与金标准数字减影血管造影(DSA)对比分析；以移植血管中段峰值流速（MG）40 cm/s为界值对移植血管闭塞风险进行评估。结果 Du-plex US对移植血管狭窄程度分级的诊断与DSA的符合率达90%；duplex US诊断移植血管狭窄的灵敏度为91.7%，特异度为92.9%，阳性预测值为84.6%，阴性预测值为96.3%，假阳性率为16.7%，假阴性率为8.3%；移植血管MG＜40 cm/s组的移植血管闭塞率（62.5%）高于≥40 cm/s组（5.4%）。结论 Duplex US与DSA对下肢动脉旁路移植术后再狭窄的诊断有较好的一致性，且duplex US具有无创、简便，患者易于接受的特点。
목적：탐토쌍공능초성（duplex US）대하지동맥방로이식술후재협착평고적림상개치。방법대아원63례고객동맥방로이식환자적80조이식혈관술후행duplex US정기수방，결합관경급혈류동역학삼수개변진행술후재협착판정，분위비현저협착조(56조)、현저협착조(15조)화폐새조(9조)，병장duplex US진단결과여금표준수자감영혈관조영(DSA)대비분석；이이식혈관중단봉치류속（MG）40 cm/s위계치대이식혈관폐새풍험진행평고。결과 Du-plex US대이식혈관협착정도분급적진단여DSA적부합솔체90%；duplex US진단이식혈관협착적령민도위91.7%，특이도위92.9%，양성예측치위84.6%，음성예측치위96.3%，가양성솔위16.7%，가음성솔위8.3%；이식혈관MG＜40 cm/s조적이식혈관폐새솔（62.5%）고우≥40 cm/s조（5.4%）。결론 Duplex US여DSA대하지동맥방로이식술후재협착적진단유교호적일치성，차duplex US구유무창、간편，환자역우접수적특점。
Objective To explore the clinical value of the duplex ultrasonography (duplex US) for evaluating the re-stenosis after peripheral arterial bypass grafting. Methods Eighty prosthetic grafts of sixty-three patients with femoral-pop-liteal arterial bypass grafting were follow-up regularly by duplex US. They were divided into non significant stenosis group (n=56), the significant stenosis group (n=15) and occlusion group (n=9) according to the tube diameter and arterial blood flow-ing parameters, which changed postoperatively. The diagnostic results were compared and analyzed between duplex US and digital subtraction angiography (DSA). The peak flow velocity of middle grafts (MG) to 40 cm/s was defined to evaluate risk of graft occlusion. Results The diagnostic coincidence rate of duplex US and DSA for grafts stenosis classification was 90%. The diagnostic sensitivity of duplex US to grafts stenosis was 91.7%, and the specificity was 92.9%. The positive pre-dictive value was 84.6%for grafts stenosis, and the negative predictive value was 96.3%, the false positive rate was 16.7%, and the false negative rate was 8.3%. The grafts occlusion rate was higher in MG<40 cm/s group than that of MG≥40 cm/s group. Conclusion There was a good consistency with Duplex US and DSA for the diagnosis of peripheral artery bypass graft restenosis. Duplex US showed characteristics of non-invasive, simple and easily accepted by patients.