CAJ | 학술논문

目的分析下腔静脉滤器(inferior vena cava filter,IVCF)继发血栓形成的治疗方法及疗效.方法回顾性分析2007年8月至2012年9月序贯治疗的10例混合型下肢深静脉血栓形成滤器置入术后继发血栓形成患者的临床资料.结果男6例,女4例,年龄(58±9)岁.本组10例患者中,滤器下方血栓形成9例,滤器内、上方及下方合并血栓形成1例;所有患者均在低分子肝素钙抗凝治疗同时,导管接触溶栓(catheter-directed thrombolysis,CDT)8例,静脉药物溶栓2例;CDT后分别造影,下腔静脉血栓完全溶解7例、部分溶解1例;临时性滤器顺利取出2例、放弃取出1例;本组患者治疗期间无肺栓塞发生;随访3 ～48个月,平均(22±10)个月,随访率为100％,随访期间死亡率为10％.经静脉药物溶栓2例,下肢、会阴部肿胀及疼痛仅略有减轻,而经CDT 8例,下肢、会阴部肿胀及疼痛均明显缓解,其中2例腰部胀痛完全消失.结论 ICVF继发血栓形成,应在充分抗凝同时,积极溶栓治疗,CDT是一种可行的有效方法,可降低后遗症的发生率.
목적 분석하강정맥려기(inferior vena cava filter,IVCF)계발혈전형성적치료방법급료효.방법 회고성분석2007년8월지2012년9월서관치료적10례혼합형하지심정맥혈전형성려기치입술후계발혈전형성환자적림상자료.결과 남6례,녀4례,년령(58±9)세.본조10례환자중,려기하방혈전형성9례,려기내、상방급하방합병혈전형성1례;소유환자균재저분자간소개항응치료동시,도관접촉용전(catheter-directed thrombolysis,CDT)8례,정맥약물용전2례;CDT후분별조영,하강정맥혈전완전용해7례、부분용해1례;림시성려기순리취출2례、방기취출1례;본조환자치료기간무폐전새발생;수방3 ～48개월,평균(22±10)개월,수방솔위100％,수방기간사망솔위10％.경정맥약물용전2례,하지、회음부종창급동통부략유감경,이경CDT 8례,하지、회음부종창급동통균명현완해,기중2례요부창통완전소실.결론 ICVF계발혈전형성,응재충분항응동시,적겁용전치료,CDT시일충가행적유효방법,가강저후유증적발생솔.
Objective To evaluate the treatment results for patients with thrombosis secondary to the inferior vena cava filter(IVCF) placement.Methods A retrospective analysis of the clinical data was performed for patients with thrombosis secondary to the IVCF from Aug 2007 to Sep 2012.Results In 10 IVCF patients,9 was below the IVCF thrombosis,1 patient with thrombosis all over the IVCF;On the basis that all patients were put on anticoagulant therapy of low molecular heparin calcium,8 patients received catheter-directed thrombolysis(CDT),2 patients received intravenous thrombolytic drug administration,after CDT angiography,showed that thrombus was completely dissolved in 7 patients and partly dissolved in 1 patient.Temporary filter was taken out in 2 patients,left in place in one.No pulmonary embolism took place in the study.All 10 patients were followed up from 3 months to 48 months,with one death.The swelling and pain of the lower limb and perineum were not significantly relieved in the 2 patients treated by venous thrombolytic drug,while these symptoms improved significantly in all the 8 CDT cases,and in 2 patients the lumbar swelling disappeared.Conclusions Treatment of thrombosis secondary to IVCF should be based on sufficient systemic anticoagulation and CDT.