急性下肢深静脉血栓形成合并重度May-Thurner综合征患者介入术中不置入下腔静脉滤器的对比研究  

A comparative study on the non-placement of inferior vena cava filter during interventional procedure for patients with acute deep venous thrombosis of the lower extremities complicated with severe May-Thurner syndrome

作　　者：陈煌 陈启鸿 高晓杰 黄仲杰 黄金旗 CHEN Huang;CHEN Qihong;GAO Xiaojie;HUANG Zhongjie;HUANG Jinqi(Department of Interventional Vascular Surgery,the First Hospital of Putian City,Putian,Fujian Province 351100,China)

机构地区：[1]莆田市第一医院介入血管外科,福建莆田351100

出　　处：《实用放射学杂志》2025年第3期474-477,共4页Journal of Practical Radiology

基　　金：莆田市科技计划项目(2024SY013)。

摘　　要：目的 探讨急性下肢深静脉血栓形成(DVT)合并重度 May-Thurner综合征(MTS)在介入治疗中下腔静脉滤器(IVCF)置入的必要性.方法 回顾性选取急性左下肢DVT合并重度MTS患者,根据是否置入IVCF分为观察组(n=36)和对照组(n=36).采用CT肺动脉血管造影(CTPA)评估肺栓塞(PE)情况,观察患肢体征改善情况及治疗期间是否出现PE临床表现,滤器取出时检查是否拦截血栓.比较2组PE新增率、住院费用、手术时间和住院周期.结果 2组介入术后血栓清除率均较高,新增小分支PE的比例较低且组间无显著差异(8.3%vs 5.6%,P=1.000).患肢体征均显著改善,治疗期间未发生PE相关临床表现.对照组滤器取出时未发现明显的拦截血栓.与对照组相比,观察组住院费用、手术时间显著降低(P<0.05).结论 对于急性下肢DVT合并重度 MTS患者,介入术中不置入IVCF并未增加PE风险,且能减少手术时间与住院费用.Objective To explore the necessity of placing an inferior vena cava filter(IVCF)during interventional therapy for acute lower extremity deep venous thrombosis(DVT)complicated with severe May-Thurner syndrome(MTS).Methods Patients with acute left lower extremity DVT complicated with severe MTS were retrospectively selected and divided into observation group(n=36)and control group(n=36)according to whether IVCF was implanted or not.Pulmonary embolism(PE)was evaluated using computed tomography pulmonary angiography(CTPA).The improvement of the affected limb signs and the occurrence of PE symptoms during treatment were observed.The presence of trapped thrombus was checked during filter removal.The PE incidence,hospitalization costs,operation time,and hospital stay were compared between the two groups.Results Both groups had a higher thrombus clearance rate after interventional surgery,and the proportion of new small branch PE was lower without significant differences between the two groups(8.3%vs 5.6%,P=1.000).The signs of the affected limbs improved significantly,and no PE-related symptoms occurred during treatment.No obvious trapped thrombus was found when the filter was removed in the control group.Compared with the control group,the observation group had significantly reduced hospitalization costs and operation time(P<0.05).Conclusion For patients with acute lower extremity DVT complicated with severe MTS,omitting IVCF placement during interventional surgery does not increase the risk of PE and can reduce operation time and hospitalization costs.

关 键 词：下肢 深静脉血栓形成 May-Thurner综合征 下腔静脉滤器 介入治疗 

分 类 号：R658.3[医药卫生—外科学] R543.6[医药卫生—临床医学] R815