下肢血管超聲診断.ppt

下肢血管超声诊断技巧 ;下肢血管检查要点;动静脉的解剖特点;动脉的特点： 壁厚，分三层：内膜，中层，外膜 张力高，探头加压管腔无明显变化;静脉的特点： 有浅、深静脉之分 大腿部深静脉：股总静脉、股浅静脉、股深静脉、腘静脉 小腿部深静脉：胫后静脉、腓静脉、胫前静脉、小腿肌肉内深静脉 (比目鱼肌静脉、腓肠肌静脉 ) 。 浅静脉：大、小隐静脉及其属支 静脉的吻合丰富 有静脉瓣 管壁薄，张力低，探头加压管腔消失 ;血管解剖及检查手法;髂血管解剖及检查手法 明确髂血管走行 从上至下找 从下至上找;股静脉解剖及检查手法 股静脉=股总静脉+股浅静脉 先找到大隐静脉 探头轻压 配合瓦氏动作 静脉分叉低于动脉分叉 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;股动脉解剖及检查手法 股动脉=股总动脉+股浅动脉 股浅动脉：髂外动脉直接延续，向下延续为腘动脉 股深动脉：向下变为几只小的穿动脉 ;正常四肢动脉频谱 呈三相波 收缩期尖峰（心脏收缩期前进的血流） 舒张早期反向血流 舒张期的正向小波（;股动脉与股静脉的关系 股总动脉在腹股沟韧带中点的深面入股三角。 在股三角内，股动脉先位于股静脉的外侧，逐渐从外侧跨到股静脉的前方，下行入收肌管，再穿收肌腱裂孔至腘窝，易名腘动脉。;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;腘动静脉、胫后动静脉解剖及检查手法 患者脚尖支在床上或检查侧脚搭在对侧的脚踝上 腘静脉位于腘动脉的后方 胫后动静脉上段是腘动静脉的直接延续，可向下追查中段情况 胫后动静脉下段在内踝下方查找，可向上追查中段情况;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;胫前动静脉解剖及检查手法 穿小腿骨间膜至小腿前面，沿骨间膜前面下降，在足背延续为足背动脉。 起始段膝关节前外下方查找 下段在小腿下段前方偏外侧查找 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;足背动静脉解剖及检查手法 在足背靠内侧部位查找 显示不清的可由胫前动脉向下追踪查找 ;Evaluation only. Created with Aspose.Slides for .NET