下腔静脉滤器植入术在下肢深静脉血栓形成治疗中的应用  

The placement of inferior vena cava filters for the treatment of deep venous thrombosis

作　　者：查斌山[1] 朱化刚[1] 谢文涛[1] 刘斌[1] 叶雨生[1] 陈智勇[1] 余康敏[1] 

机构地区：[1]安徽医科大学第一附属医院血管外科,合肥230022

出　　处：《中华普通外科杂志》2015年第9期707-710,共4页Chinese Journal of General Surgery

摘　　要：目的总结下腔静脉滤器植入术的临床效果，并探讨植入技巧及策略。方法2011年6月至2013年6月安徽医科大学第一附属医院共收治250例下肢深静脉血栓患者，其中73例行植入滤器治疗。结果本组73例中男47例，女26例，年龄36～80岁，平均年龄（51±23）岁。70例成功植入滤器，3例未能完成滤器植入术。植入永久型滤器18例，可转换滤器52例。其中25例合并肺栓塞、15例有抗凝禁忌、18例系骨创伤合并血栓、10例合并髂静脉血栓（或蔓延至下腔静脉）。经颈静脉放置6例，经对侧股静脉放置64例。滤器植入期间无肺栓塞发生或加重。滤器植入期间无患者死亡。68例患者获得随访，后期取出滤器17例，随访时间4～36个月，平均（24±10）个月，无再发肺栓塞，其中有5例下肢深静脉血栓症状性复发，经抗凝治疗后好转，未出现有严重并发症的深静脉血栓形成后遗症。结论滤器植入术可有效预防肺栓塞，需把握其适应证和禁忌证，合理选择滤器。Objective To explore the effect and technical consideration of placement of inferior vena eava filter （IVCF） in the treatment of low extremity deep venous thrombosis （DVT） . Methods From Jun 2011 to Jun 2013, 73 consecutive DVT cases were for IVCF placement. There were 47 males and 26 females with a mean age of （51 ±23 ） years （ranging from 36 to 80 years）. Results Procedures were successful in 70 out of 73 cases. There were 18 permanent and 52 temporary IVCFs deployed. The indications for filter insertion were pulmonary embolism （PE） （25 cases, 34% ）, perioperative prophylactic implantation （ 18 cases, 24% ）, contraindication to anticoagulation therapy （ 15 cases,20% ） and iliofemoral vein thrombosis（ 10 cases, 13% ）. 17 filters were successfully removed with a successful rate of 33% . After the follow-up of mean 24 months （4 to 36 months ） of 68 patients, no pulmonary embolism occurred, but symptomatic DVT recurred in 5 patients, and the conditions were improved after anticoagulation treatment. No serious complication of post thrombotic syndrome occurred. Conclusions IVCF placement is effective for prevention of PE, when the therapeutic indications and contraindications are properly controlled.

关 键 词：静脉血栓形成 腔静脉滤器 肺栓塞 

分 类 号：R654.4[医药卫生—外科学]