可回收式滤器在静脉血栓-栓塞病变介入治疗中的应用  

Retrievable vena cava filters in the interventional treatment of venous thrombi embolism

作　　者：张曦彤[1] 安建立[1] 王毅堂[2] 杨东炜 任东铭[4] 韩洪波[1] 洪铎[1] 肖亮[1] 夏永辉[1] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001 [2]沈阳242医院介入科,辽宁沈阳110033 [3]朝阳市中心医院普外科,辽宁朝阳122000 [4]鞍山钢铁集团公司总医院介入科,辽宁鞍山114002

出　　处：《中国医学影像技术》2010年第10期1964-1967,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家"十一五"科技支撑计划课题项目(2007BAI05B04)

摘　　要：目的评价两种可回收式滤器在静脉血栓-栓塞病变介入治疗中的有效性及安全性。方法 100例急性和亚急性肢体深静脉血栓形成(DVT)患者(其中肺栓塞62例)接受经导管局部溶栓的同时,置入可回收式滤器(OptEase72例,Tulip28例)。对局部溶栓效果较好者考虑进行滤器回收。结果两种滤器均成功置入下腔静脉(98例)和上腔静脉(2例),无滤器移位。除1例滤器回收失败外,24枚滤器置入后7～50天(平均18.0天)经颈静脉(Tulip滤器15例)或经股静脉(OptEase滤器9例)回收成功。患者住院期间均未发生肺栓塞加重。10例穿刺部位出现较大血肿,2例发生脑出血,4例出现肉眼血尿。结论可回收式滤器可安全用于DVT的介入治疗,防止致命性肺栓塞的发生;回收简便、安全。Objective To evaluate the efficacy,safety and ability of retrievable filters in catheter-directed thrombolysis of venous thrombi embolism. Methods One hundred patients with acute or subacute deep venous thrombosis （DVT） were treated with local catheter-directed thrombolysis and retrievable filters implantation. Seventy-two OptEase filters and 28 Gunther Tulip filters were placed in vena cava. Percutaneous filters retrieving were performed in patients with better iliac-femoral vein flow after effective local thrombolysis. Results Two kinds of filters were implanted into inferior vena cava （n=98） and superior vena cava （n=2） successfully. No filter misplaces and recurred pulmonary embolism （PE） occurred during the treatment. Except one failed retrieve of OptEase filter,15 Tulip and 9 OptEase filters were retrieved successfully through jugular or femoral route. Peri-operation complications included hematomas at access in 10 patients,intracranial hemorrhage in 2 patients and hematuria in 4 patients. Conclusion All the two kinds of the retrievable vena cava filters can be implanted and retrieved simply and safely. The retrieval of filters should be advocated for patients with DVT.

关 键 词：静脉血栓形成 肺栓塞 溶栓治疗 腔静脉滤器 

分 类 号：R816[医药卫生—放射医学] R543.6[医药卫生—临床医学]