可转换型与可回收型腔静脉滤器的临床应用  

A comparison of convertible and retrievable vena cava filters

作　　者：李津凯[1] 阚世廉[2] 李俊海[1] 张秀军[1] 黄梅[1] 殷述刚[1] 黄俊杰[1] 曹健鹏[1] 刘存发[1] 戴兵[1] 

机构地区：[1]天津医院血管外科,300211 [2]天津医院骨科,300211

出　　处：《中华普通外科杂志》2016年第7期569-572,共4页Chinese Journal of General Surgery

摘　　要：目的评价可转换型与可回收型腔静脉滤器临床应用的近期疗效、安全性和并发症。方法将81例骨折并发下肢深静脉急性血栓患者分成2组，分别放置可回收型和可转换型腔静脉滤器．对随访结果进行统计分析比较。结果81例静脉滤器均成功置入预定部位。50例可回收滤器，拦截血栓13例（26％），倾斜9例（18％）；成功回收47例（94％），回收平均耗时（5．2±2．2）min。31例可转换滤器，拦截血栓8例（25．8％），倾斜1例（3．2％）；成功转换30例（96．8％），转换平均耗时（4．2±1．6）min。在滤器倾斜发生率和滤器操控平均耗时上，可转换组均优于可回收组，差异有统计学意义（x2=3．860，P=0．049；t=2．313，P=0．023）。围手术期内2组均未发生滤器折断、移位、穿透血管壁等严重并发症。共76例获得随访，随访率93．8％，平均随访时间（11±6）个月。期间无死亡病例。结论两种腔静脉滤器均能安全、有效地减少围手术期肺栓塞的发生率。但可转换型滤器具有操作简便、转换耗时少、滤器倾斜率低、不需要取出等优势，因而更能减少因滤器置入所导致的近远期并发症。Objective To evaluate the clinical application of convertible and retrievable vena cava filters. Methods In this study, 81 bone fracture patients complicated with acute lower extremity deep vein thrombosis were divided into two groups, respectively receiving convertible or retrievable vena cava filters. Results Filters were implanted in the predetermined location in all 81 patients successfully. Among 50 retrievable cases, 13 filters have captured thrombi, 9 filters have tilted and 47 filters were successfully retrieved with the average retrieve time of 5.2 ±2.2 minutes. Among 31 convertible cases, 8 filters captured thrombi, 1 filter tilted and 30 filters were successfully converted with the average convert time of 4. 2± 1.6 minutes. Convertible filters were superior to retrievable filters in the incidence of filter tilting and control time （X2 = 3,860,t = 2. 313, P = 0. 049, P = 0. 023 ）. There was no serious complications such as filter break, shifting and pricking through vessel wails in either group. 76 patients were followed up without death report. Conclusion Both kinds of vena cava filters are able to safely and effectively reduce the incidence rate of pulmonary embolism during the perioperative period. However, the convertible filter has advantages such as easy to operate, and with short conversion time, low tihing rate and no need to be removed.

关 键 词：腔静脉滤器 深静脉血栓形成 骨折 肺栓塞 

分 类 号：R654.4[医药卫生—外科学]