下腔静脉滤器植入在无抗凝治疗下预防复发性肺栓塞的临床疗效分析  

Effectiveness of inferior vena cava filters without anticoagulation therapy for prophylaxis of recurrent pulmonary embolism

作　　者：王宝锋[1] 关敏[2] 张春峰[1] WANG Baofeng GUAN Min ZHANG Chunfeng(Department of Respiratory Medicine, Central Hospital of Baoji, Baoji, Shanxi 721008, P.R. China Department of Infectious Diseases, Central Hospital of Baoji, Baoji, Shanxi 721008, P.R.China)

机构地区：[1]宝鸡市中心医院呼吸内科,陕西宝鸡721008 [2]宝鸡市中心医院感染性疾病科,陕西宝鸡721008

出　　处：《中国呼吸与危重监护杂志》2017年第4期379-382,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨下腔静脉滤器(IVCF)植入在无抗凝治疗下预防复发性肺栓塞的临床疗效。方法回顾性分析2014年11月至2016年11月期间在我院住院治疗的265例肺栓塞患者的临床资料,按照治疗方式分为IVCF治疗组(55例)和抗凝治疗组(210例)。两组患者出院后定期门诊复查随访3个月至2年。比较两组患者一般资料、1年内肺栓塞及深静脉血栓形成(DVT)复发率,以及1年内、2年内死亡率。结果 IVCF组肺栓塞复发率为9.1%,DVT复发率为21.8%,抗凝治疗组肺栓塞复发率为18.6%,DVT复发率为11.0%。IVCF组肺栓塞复发率低于抗凝治疗组,DVT复发率高于抗凝治疗组,差异有统计学意义(P<0.05)。两组患者1年期(29.1%vs.12.9%)及2年期(34.5%vs.14.8%)死亡率比较,差异有统计学意义(P<0.05)。结论在无抗凝治疗下植入IVCF可降低下肢深静脉血栓致肺栓塞的发生率,但会提高DVT复发率,适用于肺栓塞抗凝治疗禁忌证或规范抗凝治疗后肺栓塞复发患者。Objective To explorer the application value of the inferior vena cava filter （IVCF） implantation in the prevention of recurrent pulmonary embolism （PE）. Methods Clinical data of 265 inpatients with PE admitted from November 2014 to November 2016 were retrospectively analyzed. The patients were divided into an IVCF treatment group （55 cases） and an anticoagulant therapy group （210 cases） according to treatment measure. All patients were followed up for 3 months to 2 years through regular review. The one-year PE and deep vein thrombosis （DVT） recurrence rates, one-year mortality and two-year mortality were compared between two groups. Results The PE and DVT recurrence rates were 9.1% and 21.8% in the IVCF treatment group, and were 18.6% and 11.0% in the anticoagulant therapy group, respectively. The PE recurrence rate was lower and the DVT recurrence rate was higher in the IVCF treatment group compared with the anticoagulant therapy group, the differences were statistically significant （P〈0.05）. The one-year mortality （29.1% vs. 12.9%） and two-year mortality （34.5% vs. 14.8%） were significantly higher in the IVCF treatment group than those in the anticoagulant therapy group （P〈0.05）. Conclusions IVCF without anticoagulation can reduce incidence of pulmonary embolism caused by the lower extremity DVT, but will increase DVT recurrence rate. It may be an alternative option for prevention of PE in patients with contraindications to anticoagulant therapy or recurrent PE patients after regular anticoagulant therapy.

关 键 词：下腔静脉滤器 抗凝 预防 复发性肺栓塞 

分 类 号：R563.5[医药卫生—呼吸系统]