中国血管外科杂志（电子版）
中國血管外科雜誌（電子版）
중국혈관외과잡지（전자판）
CHINESE JOURNAL OF VASCULAR SURGERY(ELECTRONIC VERSION)
2013年
3期
161-165
,共5页
潘烨%邵明哲%张健%吴海生%梅家才%张长青%孙玉强%赵珺
潘燁%邵明哲%張健%吳海生%梅傢纔%張長青%孫玉彊%趙珺
반엽%소명철%장건%오해생%매가재%장장청%손옥강%조군
静脉血栓形成%肺栓塞%腔静脉滤器%骨折
靜脈血栓形成%肺栓塞%腔靜脈濾器%骨摺
정맥혈전형성%폐전새%강정맥려기%골절
Venous thrombosis%Pulmonary embolism%Vena cava filter%Bone fracture
目的探讨可回收腔静脉滤器在骨创伤合并下肢深静脉血栓形成（DVT）患者中的应用和提高滤器取出率的途径。方法对2007年7月~2012年12月我院收治的486例骨创伤合并下肢DVT（均经下肢血管多普勒超声检查诊断）患者的临床资料进行回顾性分析。患者于骨科手术前均置入可回收滤器，以预防围手术期发生致命性肺梗塞（PE）。采用圈套器联合导丝牵拉法处理倾斜滤器；对滤器内大块血栓置管溶栓治疗。结果486例可回收腔静脉滤器均置入成功。围手术期无症状性PE发生。滤器在体内的留置时间为（18.4±4.3）d，其中152例捕获到血栓。447例患者进行了滤器取出操作，共取出滤器441个，技术成功率为98.7%,6例取出失败。总的滤器取出率为90.7%。结论可回收滤器用于骨创伤合并下肢DVT患者可有效预防PE。完善的患者信息登记和随访、妥善处理滤器内血栓和滤器倾斜，有助于提高滤器取出率，更好地发挥可回收滤器的优势。
目的探討可迴收腔靜脈濾器在骨創傷閤併下肢深靜脈血栓形成（DVT）患者中的應用和提高濾器取齣率的途徑。方法對2007年7月~2012年12月我院收治的486例骨創傷閤併下肢DVT（均經下肢血管多普勒超聲檢查診斷）患者的臨床資料進行迴顧性分析。患者于骨科手術前均置入可迴收濾器，以預防圍手術期髮生緻命性肺梗塞（PE）。採用圈套器聯閤導絲牽拉法處理傾斜濾器；對濾器內大塊血栓置管溶栓治療。結果486例可迴收腔靜脈濾器均置入成功。圍手術期無癥狀性PE髮生。濾器在體內的留置時間為（18.4±4.3）d，其中152例捕穫到血栓。447例患者進行瞭濾器取齣操作，共取齣濾器441箇，技術成功率為98.7%,6例取齣失敗。總的濾器取齣率為90.7%。結論可迴收濾器用于骨創傷閤併下肢DVT患者可有效預防PE。完善的患者信息登記和隨訪、妥善處理濾器內血栓和濾器傾斜，有助于提高濾器取齣率，更好地髮揮可迴收濾器的優勢。
목적탐토가회수강정맥려기재골창상합병하지심정맥혈전형성（DVT）환자중적응용화제고려기취출솔적도경。방법대2007년7월~2012년12월아원수치적486례골창상합병하지DVT（균경하지혈관다보륵초성검사진단）환자적림상자료진행회고성분석。환자우골과수술전균치입가회수려기，이예방위수술기발생치명성폐경새（PE）。채용권투기연합도사견랍법처리경사려기；대려기내대괴혈전치관용전치료。결과486례가회수강정맥려기균치입성공。위수술기무증상성PE발생。려기재체내적류치시간위（18.4±4.3）d，기중152례포획도혈전。447례환자진행료려기취출조작，공취출려기441개，기술성공솔위98.7%,6례취출실패。총적려기취출솔위90.7%。결론가회수려기용우골창상합병하지DVT환자가유효예방PE。완선적환자신식등기화수방、타선처리려기내혈전화려기경사，유조우제고려기취출솔，경호지발휘가회수려기적우세。
Objective To evaluate the application of retrievable inferior vena cava filter (rIVCF) in patients of bone fracture combined with deep venous thrombosis (DVT) , and the methods to improve the rIVCF retrieval rates. Methods From July 2007 to December 2012, the clinical data of 486 cases of bone fracture combined with DVT were studied retrospectively, and the patients were diagnosed by Doppler ultrasound. Patients were received rIVCF implantation before orthopedic surgery to prevent the perioperative pulmonary embolism (PE). The snare-over-guide wire loop technique was used to handle with tilted filters. Thrombolytic therapy was applied to deal with large thrombus trapped in filters. Results All of the 486 rIVCFs were successfully deployed. No PE occurred in the perioperative period. The mean implanting time of rIVCFs in inferior vena cava was (18.4±4.3) days, and among which, trapped thrombi were found in 152 cases. 447 rIVCFs were attempted to be removed, but failed in six cases. The technique success ratio of retrieving was 98.7%, while the total retrieval rate was 90.7%. Conclusion rIVCF can prevent trauma patients with DVT from fatal PE. Comprehensive patient registration, strict follow-up, proper management with tilted filters and large thrombus in filters contribute to the improvement of retrieval rates.
