中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
11期
835-838
,共4页
冯亚平%张福先%罗小云%梁刚柱%张昌明%牛鹿原%张欢%郭梅梅
馮亞平%張福先%囉小雲%樑剛柱%張昌明%牛鹿原%張歡%郭梅梅
풍아평%장복선%라소운%량강주%장창명%우록원%장환%곽매매
静脉血栓形成%腔静脉滤器%肺栓塞
靜脈血栓形成%腔靜脈濾器%肺栓塞
정맥혈전형성%강정맥려기%폐전새
Venous thrombosis%Vena cava filters%Pulmonary embolism
目的 评价下腔静脉滤器(vena cava filter,VCF)植入的中-长期临床疗效与并发症.方法 回顾性分析1998年8月至2012年8月首都医科大学附属北京世纪坛医院行VCF植入术272例患者,按照无抗凝、常规抗凝治疗、抗凝结合手术取栓或局部导管溶栓加支架术等分为3组,A组(19例)、B组(112例)、C组(141例),分别对患者的腔静脉通畅率、肺动脉栓塞(pulmonary embolism,PE)及并发症的发生情况进行分析、总结.结果 本组患者手术均获成功,围手术期无严重并发症及症状性PE发生.随访时间3个月至9年,平均(3.8±1.2)年.远期新发PE 3例;深静脉血栓形成(deep vein thrombosis,DVT)复发29例;血栓后综合征(post thrombosis syndrome,PTS)40例;症状性下腔静脉血栓形成19例,完全闭塞9例.腔静脉通畅情况:3年以上累计通畅率为88.64％;其中A组84.2％,B组96.43％,C组98.58％,B、C组均好于A组;DVT发生在左下肢者腔静脉通畅率(98.65％),较右下肢(90.32％)及双下肢(83.33％)患者为高.结论 VCF预防PE安全、有效,同时作为综合性治疗的重要辅助手段提高了静脉血栓栓塞症的疗效.VCF术后规范抗凝治疗可提高远期腔静脉通畅率.
目的 評價下腔靜脈濾器(vena cava filter,VCF)植入的中-長期臨床療效與併髮癥.方法 迴顧性分析1998年8月至2012年8月首都醫科大學附屬北京世紀罈醫院行VCF植入術272例患者,按照無抗凝、常規抗凝治療、抗凝結閤手術取栓或跼部導管溶栓加支架術等分為3組,A組(19例)、B組(112例)、C組(141例),分彆對患者的腔靜脈通暢率、肺動脈栓塞(pulmonary embolism,PE)及併髮癥的髮生情況進行分析、總結.結果 本組患者手術均穫成功,圍手術期無嚴重併髮癥及癥狀性PE髮生.隨訪時間3箇月至9年,平均(3.8±1.2)年.遠期新髮PE 3例;深靜脈血栓形成(deep vein thrombosis,DVT)複髮29例;血栓後綜閤徵(post thrombosis syndrome,PTS)40例;癥狀性下腔靜脈血栓形成19例,完全閉塞9例.腔靜脈通暢情況:3年以上纍計通暢率為88.64％;其中A組84.2％,B組96.43％,C組98.58％,B、C組均好于A組;DVT髮生在左下肢者腔靜脈通暢率(98.65％),較右下肢(90.32％)及雙下肢(83.33％)患者為高.結論 VCF預防PE安全、有效,同時作為綜閤性治療的重要輔助手段提高瞭靜脈血栓栓塞癥的療效.VCF術後規範抗凝治療可提高遠期腔靜脈通暢率.
목적 평개하강정맥려기(vena cava filter,VCF)식입적중-장기림상료효여병발증.방법 회고성분석1998년8월지2012년8월수도의과대학부속북경세기단의원행VCF식입술272례환자,안조무항응、상규항응치료、항응결합수술취전혹국부도관용전가지가술등분위3조,A조(19례)、B조(112례)、C조(141례),분별대환자적강정맥통창솔、폐동맥전새(pulmonary embolism,PE)급병발증적발생정황진행분석、총결.결과 본조환자수술균획성공,위수술기무엄중병발증급증상성PE발생.수방시간3개월지9년,평균(3.8±1.2)년.원기신발PE 3례;심정맥혈전형성(deep vein thrombosis,DVT)복발29례;혈전후종합정(post thrombosis syndrome,PTS)40례;증상성하강정맥혈전형성19례,완전폐새9례.강정맥통창정황:3년이상루계통창솔위88.64％;기중A조84.2％,B조96.43％,C조98.58％,B、C조균호우A조;DVT발생재좌하지자강정맥통창솔(98.65％),교우하지(90.32％)급쌍하지(83.33％)환자위고.결론 VCF예방PE안전、유효,동시작위종합성치료적중요보조수단제고료정맥혈전전새증적료효.VCF술후규범항응치료가제고원기강정맥통창솔.
Objective To evaluate the mid-and long-term clinical curative effect and complications after inferior vena cava filter (VCF) implantation.Methods Clinical data of 272 patients from August 1998 to August 2012 in our hospital were retrospectively reviewed and patients were divided into group A (19 cases) in which no anticoagulant was given,group B (112 cases) receiving conventional anticoagulant therapy,and group C (141 cases) managed with anticoagulation plus embolectomy or catheter directed thrombolysis and stent implantation.The caval patency rate,PE events and complications were analyzed.Results Filter implantation was successful in all the 272 cases.There was no procedure-related serious complications and symptomatic pulmonary embolism (PE).Patients were followed-up from 3 months to 9 years,with an average of 3.8 ± 1.2 years.The number of new-onset PE was 3,recurrent DVT was 29,and PTS was 40.There were 19 patients presenting inferior vena cava thrombosis,with complete IVC occlusion in 9 cases.3 year patency rate was 88.64％ ; Patency rate of vena cava respectively was:84.2％ in group A,96.43％ in group B,98.58％ in group C.Vena cava patency rate was higher with DVT originating in the left lower limb (98.65％) than that in the right (90.32％) and bilateral limbs (83.33％).Conclusions VCF can prevent PE safely and effectively.It helps to establish a comprehensive treatment to improve the prognosis of VTE.
