经肘下腔静脉滤器置入术六例  

Vena cava filter placement via the antecubital access:a report of 6 cases

作　　者：余波[1] 史伟浩[1] 何勍 王铁平[1] 王巍[2] 

机构地区：[1]复旦大学附属华山医院血管外科,上海200040 [2]复旦大学附属华山医院放射介入科,上海200040

出　　处：《介入放射学杂志》2008年第8期590-591,共2页Journal of Interventional Radiology

摘　　要：目的探讨经肘下腔静脉滤器置入的方法及并发症的防治。方法2004年10月至2006年5月我科收治的下肢深静脉血栓形成(DVT)患者中,有6例采取经肘静脉穿刺下腔静脉滤器置入。6例均经右肘正中静脉或贵要静脉穿刺,将SNF(Simon nitinol filter,Bard)沿90cm长鞘置入下腔静脉。结果6例手术均1次成功,用时平均25min。除1例肘部穿刺点有轻度红肿外,其余均愈合良好,无出血或血肿,无静脉炎。滤器位置准确,无偏斜。患者均无肺栓塞发生。结论经肘下腔静脉滤器置入术穿刺容易,创伤小,术后患者无需卧床制动,有利于DVT的治疗。同时,对于经股静脉穿刺有禁忌的DVT患者,经肘下腔静脉滤器置入更不失为较好的替换选择。Objective To study the methods and skill of vena cava filter placement via the antecubital access. Methods Six patients with DVT （4 males and 2 females, mean age of 62） underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF （Simon nitinol filter, Bard）was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access.

关 键 词：下肢深静脉血栓形成 下腔静脉滤器 经肘下腔静脉滤器置入 

分 类 号：R543.6[医药卫生—心血管疾病]