大腿静脈エコーが診断と治療経過観察に有用であった深部静脈血栓症の2例

Two Cases of Deep Vein Thrombosis:Image-directed Doppler ultrasound examinations of the femoral veins was helpful for both diagnosis and treatment

　深部静脈血栓症は肺血栓症を併発し，時に致死的となる．したがって，早期に深部静脈血栓症と診断し治療を開始することは，肺血栓症を予防するためにも重要である．われわれは下肢浮腫を主訴に受診した2例に大腿静脈エコーを施行し，深部静脈血栓症と診断し治療によって改善する経過を観察しえたので，本法の臨床的有用性を検討する．この2例は，下肢の浮腫・緊満を主訴に入院し，大腿静脈エコーで患側の大腿静脈を観察すると，ウインクサイン陰性，ドプラエコーで血流が検出されず深部静脈血栓症と診断した．両者とも発症より比較的早期に受診しており，積極的に抗凝固療法を行ったところ，再検査時には血流再開が観察された．本法は静脈造影と比較して，下肢静脈全体の観察はやや困難であるが，非観血的であり，血流の情報を含めた検討が繰り返し可能であり有用であると考える．

Deep vein thrombosis (DVT) can be fatal when com-plicated with pulmonary thromboembolism (PTE). It is important, therefore, to diagnose and start to medicate in the early stage to prevent the development of PTE. We report two cases of DVT which presented edema in the lower extremities. We diagnosed them as DVT by femoral vein echography and observed the process of the thrombolysis. The two patients were admitted for further examination because of marked edema and swelling in their legs. Femoral vein echography revealed DVT with a negative “wink sign” and doppler echogra-phy showed there was no blood supply. After anticoagulant therapy for more than one month, revas-culization was confirmed by echography. Femoral echo-graphy may be very useful for the diagnosis and the treatment of DVT because of its being non-invasive and being able to estimate blood flow or lack of it by doppler echo.