临时滤器联合经导管血栓抽吸术和导管接触性溶栓治疗下腔静脉血栓  

Temporary filter combined with transcatheter thrombus aspiration and catheter directed thrombolysis in the treatment of inferior vena cava thrombosis

作　　者：张志文[1] 陈学明[1] 冯海[1] 李晨宇[1] 于宏志[1] 张忠涛[2] Zhang Zhiwen;Chen Xueming;Feng Hai;Li Chenyu;Yu Hongzhi;Zhang Zhongtao(Department of Vascular Surgery,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China;Department of General Surgery,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院血管外科,北京100050 [2]首都医科大学附属北京友谊医院普外科,北京100050

出　　处：《中国血管外科杂志（电子版）》2020年第3期222-226,共5页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨临时滤器联合经导管血栓抽吸术和CDT治疗下腔静脉血栓(inferior vena cava thrombosis,IVCT)的安全性和有效性。方法分析2015年1月至2018年12月在首都医科大学附属北京友谊医院治疗的47例IVCT患者资料,采用TempofilterⅡ临时滤器置入术,经腘静脉或股静脉进行导管吸栓后行CDT,统计技术成功率、临床成功率、并发症、术后血栓形成后综合征(post thrombosis syndrome,PTS)发生率和通畅率。结果临床成功率100%,技术成功率100%,滤器拔出时间为12~31 d。吸栓后有8例患者可见滤器处拦截血栓。溶栓时间为1~5 d,平均(2.68±1.00)d。患者吸栓术后第1天、溶栓导管拔除当天和出院时的下肢周长均小于术前,差异均有统计学意义(P<0.001)。患者术后6、12、18和24个月的下腔静脉通畅率分别为95.7%,93.3%,91.2%和85.2%,术后2年的PTS发生率为10.8%(4/37)。结论临时滤器联合经导管血栓抽吸术和CDT可快速缓解IVCT患者临床症状,是一种安全有效的治疗方法。Objective To investigate the safety and validity of temporary filter combined with transcatheter thrombus aspiration and catheter-directed thrombolysis(CDT)in treatment of inferior vena cava thrombosis(IVCT).Methods We analyzed the clinical data of 47 patients with IVCT who adopt TempofilterⅡfilter implantation combined with transcatheter thrombus aspiration through popliteal vein or femoral vein and CDT from January 2015 to December 2018.Technology success rate,clinical success rate,complications,post-thrombosis syndrome(PTS)incidence and patency rate were counted.Results The clinical success rate and the technical success rate were 100%.The filter extraction time was 12 to 31 days.After the thrombus was sucked,8 patients could see thrombus intercepted at the filter.The thrombolysis time was 1 to 5 days,with an average of(2.68±1.00)days.The circumference of the lower extremities on the first day after thrombectomy,on the day of thrombectomy catheter removal and on discharge were smaller than before surgery,and the differences were statistically significant(P<0.001).The inferior vena cava patency rates at 6,12,18 and 24 months after operation were 95.7%,93.3%,91.2%and 85.2%,respectively.The incidence of PTS at 2 years after surgery was 10.8%(4/37).Conclusion Temporary filter combined with transcatheter thrombus aspiration and CDT can quickly relieve the clinical symptoms of IVCT patients,which is a safe and effective treatment.

关 键 词：滤器 下腔静脉血栓 血栓抽吸术 导管接触性溶栓 

分 类 号：R654.4[医药卫生—外科学]