临时性肾上下腔静脉滤器在静脉血栓栓塞症中的应用  

Temporary suprarenal inferior vena cava filter in the venous thromboembolism

作　　者：郑学洵 薛明[1] 周亚东[1] 官云彪[1] Zheng Xuexun;Xue Ming;Zhou Yadong;Guan Yunbiao(Department of Vascular Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学附属协和医院血管外科,福建福州350001

出　　处：《血管与腔内血管外科杂志》2023年第1期15-19,共5页Journal of Vascular and Endovascular Surgery

基　　金：福建医科大学附属协和医院医疗“创双高”项目。

摘　　要：目的 探讨临时性肾上下腔静脉滤器(IVCF)在静脉血栓栓塞症(VTE)中的应用情况。方法 收集2013年1月至2021年12月于福建医科大学附属协和医院行临时性肾上IVCF的28例VTE患者的临床资料,所有患者均接受抗凝和/或溶栓、吸栓治疗,待肺栓塞(PE)风险解除后均取出肾上IVCF。观察IVCF置入及取出情况、围手术期并发症发生情况、IVCF留置时间,比较治疗前后血肌酐水平的变化情况,记录IVCF断裂、移位、倾斜等情况。结果 28例患者均成功置入IVCF,成功率为100%,其中,22例置入Optease滤器,置入时间为6.00(5.00,7.00)d;2例置入Aegisy滤器,置入时间分别为7、10 d;4例置入Denali滤器,置入时间为34.50(29.00,39.25)d。28例患者均成功取出滤器,围手术期均未出现颅脑出血、腹腔出血、PE、滤器断裂或移位等。随访期间,1例患者左下肢静脉血栓复发,加强抗凝治疗后好转,其他患者均未发生PE、滤器断裂或移位等。治疗前后血肌酐水平比较,差异无统计学意义(P﹥0.05)。结论 VTE患者行临时性肾上IVCF放置及取出安全、有效,待血栓清除干净或PE风险解除后均应尽早回收,从而减少留置时间过长导致的严重并发症。Objective To explore the application of temporary suprarenal inferior vena cava filter(IVCF) in the venous thromboembolism(VTE). Method A total of 28 VTE patients treated with temporary suprarenal IVCF in the Fujian Medical University Union Hospital from January 2013 to December 2021 were selected. All patients received anticoagulation and/or thrombolysis and embolectomy. After the risk of pulmonary embolism was relieved, the suprarenal IVCF was removed.The insertion and removal of IVCF, perioperative complications, IVCF indwelling time were observed, change of creatinine before and after treatment was compared, the rupture, displacement and inclination of IVCF were recorded. Result IVCF was inserted in 28 cases, with successful rate of 100%, Optease filter was placed in 22 cases with indwelling time of 6.00(5.00,7.00) d;Aegisy filter was placed in 2 cases with indwelling time of 7, 10 d. Denali filter was placed in 4 cases, the implantation time was 34.50(29.00, 39.25) d. The filters were successfully removed in 28 cases, and there were no cases of craniocerebral,abdominal hemorrhage, PE, filter rupture or displacement. During follow-up, 1 patient experienced recurrence of left extremity venous thromboembolism, which relieved after anticoagulation treatment, and no other patients experienced PE, filter rapture or displacement. There was no difference for the creatinine before and after treatment(P>0.05). Conclusion The insertion and removal of temporal suprarenal IVCF in VTE patients are safe and effective, which should be recovered promptly after clearance of embolism or relief of PE risk to reduce severe complications caused by prolonged indwelling time.

关 键 词：静脉血栓栓塞症 下腔静脉滤器 肾上静脉 溶栓 

分 类 号：R543[医药卫生—心血管疾病]