腔静脉滤器在急性深静脉血栓形成患者系统溶栓治疗中的必要性探讨  

Discussion of the necessity of placing vena cava filter in systemic thrombolytic therapy for patients with acute deep vein thrombosis

作　　者：石灿 陈榕 陈鹏姿 吴甜[1] SHI Can;CHEN Rong;CHEN Pengzi;WU Tian(The third Xiangya Hospital of Central South University,Changsha 410013,Hunan,China;People's Hospital of Huayuan County,Xiangxi 416400,Hunan,China;Wuxi Community Health Service Center,Yongzhou 426199,Hunan,China)

机构地区：[1]中南大学湘雅三医院,湖南长沙410013 [2]花垣县人民医院,湖南湘西416400 [3]浯溪社区卫生服务中心,湖南永州426199

出　　处：《中国临床药理学与治疗学》2021年第12期1413-1418,共6页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：湖南省自然科学基金项目(2020JJ5870);中南大学大型仪器共享基金项目(CSUZC201936)。

摘　　要：目的:探讨急性深静脉血栓形成(deep venous thrombosis, DVT)患者行溶栓治疗时,置入下腔静脉滤器的必要性。方法:回顾性总结2006年9月至2020年4月间,中南大学湘雅三医院因深静脉血栓行尿激酶溶栓治疗的患者临床资料,探讨放置下腔静脉滤器的必要性。结果:共收集病人549例,其中滤器组294例(男154例,女140例),未放滤器组255例(男126例,女129例)。滤器组近端DVT 268例,溶栓治疗前有35例合并肺栓塞;未放滤器组近端DVT 218例,溶栓治疗前有16例合并肺栓塞,两组间具有统计学差异(P值分别为0.038和0.023)。滤器组尿激酶总量为(163.63±91.00)万单位,未放滤器组尿激酶总量为(149.02±77.72)万单位,两组间具有统计学差异(P=0.045),但尿激酶溶栓天数及足量抗凝患者比例均无统计学差异。本研究255例未放滤器溶栓患者只有1例患者发生溶栓后肺栓塞(P=0.282)。结论:急性深静脉血栓形成患者行溶栓治疗时不必常规置入腔静脉滤器。AIM: To investigate the necessity of placing inferior vena cava filter in systemic thrombolytic therapy for patients with acute deep vein thrombosis. METHODS: Retrospectively summarized the clinical data of patients who received urokinase for deep vein thrombosis in the Third Xiangya Hospital of Central South University from September 2006 to April 2020, and discussed the necessity of placing inferior vena cava filter. RESULTS: A total of 549 patients were enrolled, including 294 patients in the filter group(154 males, 140 females) and 255 patients in the non-filter group(126 males, 129 females). Among 268 cases of proximal DVT in the filter group, thirty-five cases were complicated with pulmonary embolism before thrombolysis;and there were 218 cases of proximal DVT in the non-filter group and 16 cases of pulmonary embolism before thrombolysis, with statistical difference between the two groups(P=0.038 and 0.023, respectively). The total amount of urokinase in the filter group was(1 636.3±910.0) thousand units, and that in the non-filter group was(1 490.2±777.2) thousand units, with statistical difference between the two groups(P=0.045). However, there were no statistical differences in the days of use of urokinase and the proportion of patients with adequate anticoagulation. In this study, among 255 patients in non-filter group underwent thrombolysis, only 1 patient developed pulmonary embolism after thrombolysis(P=0.282). CONCLUSION: Inferior vena cava filter is not always necessary for patients with acute deep vein thrombosis during systemic thrombolytic therapy.

关 键 词：腔静脉滤器 静脉血栓形成 尿激酶溶栓 肺栓塞 

分 类 号：R473.6[医药卫生—护理学]