经大隐静脉置入下腔静脉滤器的临床应用  

Clinical application of inferior vena cava filter placement through great saphenous vein

作　　者：季必宏[1] 许海林[1] 王文荣[1] 邹伟荣[1] 韩业红[1] 陈健[1] 张红东[1] 

机构地区：[1]浙江大学医学院附属第二医院建德分院普通外科,浙江建德311600

出　　处：《全科医学临床与教育》2013年第5期531-534,共4页Clinical Education of General Practice

基　　金：浙江省医学会临床科研基金项目(2010ZYC-A26)

摘　　要：目的探讨经大隐静脉置入下腔静脉滤器（IVCF）的安全性和可行性。方法将有IVCF 置入指征的60例单侧下肢深静脉血栓形成患者随机分成经股静脉组（30例）和经大隐静脉组（30例），分别经股静脉穿刺和大隐静脉切开置入IVCF，比较两组患者的手术时间、切口长度、术后住院时间及并发症情况。结果两组60例患者均成功实施IVCF置入，无围手术期死亡患者。大隐静脉组手术时间与股静脉组比较，差异无统计学意义（t=0.29，P＞0.05），大隐静脉组手术切口长度长于腔静脉组，差异有统计学意义（t=-24.70，P＜0.05），术后下床活动时间、术后住院时间均较股静脉短，差异均有统计学意义（t分别=35.04、3.30，P均＜0.05）。大隐静脉组术后发生并发症例数和穿刺口点血肿明显少于股静脉组，差异有统计学意义（χ2分别=6.67、7.93，P均＜0.05），两组均无死亡病例及切口感染病例。结论因经大隐静脉置入IVCF、安全可行，并发症发生率较低，是一种新型、可供选择的手术方式之一。Objective To evaluate the feasibility and safety of vena cana filter （IVCF） placement through great saphe-nous vein. Methods Sixty cases of deep venous thrombosis（DVT） in unilateral lower limb who had the indication of IVCF placement were randomly divided into femoral vein group（30 patients） who were inserted IVCF through femoral vein punc-ture and great saphenous vein group （30 patients） who were inserted IVCF through great saphenous vein. The operation time, incision length, hospital stay and complications between two groups were compared. Results Sixty cases in two groups were inserted IVCF successfully without dead case. The surgical time had no significant difference between two groups （t=0.29,P〉0.05）. The incision length of saphenous vein group was significantly longer than that of femoral vein group（t=-24.70,P〈0.05）while the leaving bed time and hospital stay were significantly shorter than femoral vein group（t=35.04,3.30,P〈0.05）.The complications and the incidences of hematoma at the site of the insertion in saphenous vein group were significantly less than those of femoral vein group （χ2=6.67,7.93,P〈0.05）. Conclusion The placement of IVCF through great saphenous vein is a safe, feasible and lower incidence of complications operation method.

关 键 词：下肢深静脉血栓形成 大隐静脉 腔静脉滤器 

分 类 号：R654.3[医药卫生—外科学]