目的 研究超声检查胡桃夹综合征（nutcracker syndrome，NCS）背伸位时间及呼吸状态对诊断结果的影响，从而优化检查流程。 方法 收集55例NCS为观察组，41例健康者为对照组，两组分别于平卧位、脊柱背伸位的四个时段（0~5 min、5~10 min、10~15 min、15~20 min）的平静呼吸、吸气末、呼气末，应用二维超声及频谱多普勒测量夹角（θ）、夹角处内径（D1）、远心端内径（D2）、夹角处血流速度峰值（PVN）及远心端血流速度峰值（PVD）等参数，并进行对比分析。 结果 观察组脊柱背伸位15~20 min平静呼吸时D2/D1大于5~10 min和10~15 min时（P<0.05），但三个时段诊断灵敏度差异不大，吸气末和呼气末，以上4个时段D2/D1差异无统计学意义；检查过程中吸气会导致θ减小、D2/D1升高，呼气反之。 结论 超声检查“胡桃夹”综合征患者时，背伸位时间对检查结果影响不大，吸气会导致阳性率提升，呼气会导致阳性率下降，平静呼吸时阳性率居中，故检查过程中可缩短背伸位时间，嘱患者不要用力吸气或呼气，尽量保持平静呼吸状态接受检查。
Abstract
Objective To study the effect of ultrasound in the diagnosis of the nutcracker syndrome, so as to optimize examination process. Methods Fifty-five NCS were collected as the observation group, forty-one healthy patients were included in the control group. These two groups were in the supine position, dorsal extension (divided into four groups: 0 min-5 min, 5 min-10 min, 10 min-15 min, and 15 min-20 min). In calm breathing, end of inhalation and end of breath, 2D ultrasound and spectral Doppler measuring angle (θ), inner diameter (D1), distal heart inner diameter (D2), peak flow velocity (PVN), distal heart peak flow velocity (PVD) and other parameters were recorded and they were performed a comparative analysis. Results In the observation group, the D2/D1 of dorsal extension of the spine for 15 min-20 min and when calm breathing was slightly greater than that of 5min-10min and 10min-15min (P<0.05). However, the diagnostic sensitivity differences among the three time periods are not significant, and there was no statistically significant difference in D2/D1 between the above four time periods. Inhalation during the test resulted in a decrease in angle θ and an increase in D2/D1, and exhale was the opposite. Conclusions In the course of examining patients with nutcracker syndrome, the length of back extension has little effect on the examination results, ultrasound in the process of examination in patients with nutcracker syndrome, inhale can lead to positive rate increase, breathing out can lead to positive rate decline, and the positive rate is in the middle when breathing calmly. Therefore, the back extension time can be shortened during the inspection process, then tell the patients not to inhale or exhale, try to calm breathing in the examination.
关键词
超声检查 /
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多普勒 /
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胡桃夹综合征 /
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左肾静脉 /
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背伸位
Key words
Ultrasonography /
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Doppler /
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Nutcracker syndrome /
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Left renal vein /
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Dorsal extension
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