滤器置入联合手术取栓治疗产后下肢DVT的临床分析  

Treatment of postpartum lower extremity DVT by filter placement combined with embolectomy

作　　者：张铠[1] 郭曙光[1] 周兴立[1] 方伟[1] 曾燏[2] 

机构地区：[1]成都军区昆明总医院血管外科,昆明650032 [2]成都军区昆明总医院地干病房,昆明650032

出　　处：《西南国防医药》2013年第5期491-493,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的总结产后急性期单侧下肢深静脉血栓形成(DVT)腔静脉滤器联合手术取栓治疗的疗效及应用。方法回顾性分析59例产后单侧下肢急性期DVT行腔静脉滤器联合手术取栓治疗的患者临床资料。结果 56例成功行腔静脉滤器置入及手术切开取栓,3例因髂静脉近端血栓闭塞严重无法开通,股静脉切口远端成功行手术取栓,术后拔除腔静脉滤器。本组有效率为100%,治愈率为88.1%,无死亡及新发肺动脉栓塞病例。随访3～36个月,1例髂静脉狭窄病例于球囊扩张3个月后复发,再次手术置入髂静脉支架后患肢肿胀明显减轻。结论腔静脉滤器置入联合手术取栓治疗急性期产后单侧下肢DVT安全可行、疗效确切。Objective To summarize the curative effects of application of vena cava filter placement combined with embolectomy on the postpartum unilateral lower extremity deep venous thrombosis in acute phase. Methods Retrospective analysis was made in the clinical data of patients with postpartum unilateral lower extremity deep venous thrombosis in acute phase and receiving the vena cava filter placement combined with embolectomy. Results Fifty six cases successfully underwent the vena cava filter placement combined with embolectomy. Three cases underwent the emboleetomy via distal femoral vein incision due to the proximal iliac vein thrombus block,and the vena cava filter was removed after the operation. The effective rate was 100% ,and the cure rate was 88.1%. No death and new case of pulmonary embolism occurred. Follow-up was made for 3-36 months, 1 case of iliac vein stenosis relapsed 3 months after the saeeule expansion. The limb swelling was significantly relieved after the placement of iliac vein stent by operation. Conclusion Vena cava filter placement combined with embolectomy is safe and feasible in the treatment of postpartum unilateral lower extremity deep vein thrombosis in acute period, and the curative effect is exact.

关 键 词：下肢深静脉血栓形成 股静脉取栓 可回收下腔静脉滤器 围产期 

分 类 号：R658.3[医药卫生—外科学]