CAJ | 학술논문

目的总结下腔静脉滤器植入术的临床效果,并探讨植入技巧及策略.方法 2011年6月至2013年6月安徽医科大学第一附属医院共收治250例下肢深静脉血栓患者,其中73例行植入滤器治疗.结果本组73例中男47例,女26例,年龄36 ～80岁,平均年龄(51±23)岁.70例成功植入滤器,3例未能完成滤器植入术.植入永久型滤器18例,可转换滤器52例.其中25例合并肺栓塞、15例有抗凝禁忌、18例系骨创伤合并血栓、10例合并髂静脉血栓(或蔓延至下腔静脉).经颈静脉放置6例,经对侧股静脉放置64例.滤器植入期间无肺栓塞发生或加重.滤器植入期间无患者死亡.68例患者获得随访,后期取出滤器17例,随访时间4 ～ 36个月,平均(24±10)个月,无再发肺栓塞,其中有5例下肢深静脉血栓症状性复发,经抗凝治疗后好转,未出现有严重并发症的深静脉血栓形成后遗症.结论滤器植入术可有效预防肺栓塞,需把握其适应证和禁忌证,合理选择滤器.
목적 총결하강정맥려기식입술적림상효과,병탐토식입기교급책략.방법 2011년6월지2013년6월안휘의과대학제일부속의원공수치250례하지심정맥혈전환자,기중73례행식입려기치료.결과본조73례중남47례,녀26례,년령36 ～80세,평균년령(51±23)세.70례성공식입려기,3례미능완성려기식입술.식입영구형려기18례,가전환려기52례.기중25례합병폐전새、15례유항응금기、18례계골창상합병혈전、10례합병가정맥혈전(혹만연지하강정맥).경경정맥방치6례,경대측고정맥방치64례.려기식입기간무폐전새발생혹가중.려기식입기간무환자사망.68례환자획득수방,후기취출려기17례,수방시간4 ～ 36개월,평균(24±10)개월,무재발폐전새,기중유5례하지심정맥혈전증상성복발,경항응치료후호전,미출현유엄중병발증적심정맥혈전형성후유증.결론 려기식입술가유효예방폐전새,수파악기괄응증화금기증,합리선택려기.
Objective To explore the effect and technical consideration of placement of inferior vena cava filter (IVCF) in the treatment of low extremity deep venous thrombosis (DVT).Methods From Jun 2011 to Jun 2013,73 consecutive DVT cases were for IVCF placement.There were 47 males and 26 females with a mean age of (51 ± 23) years (ranging from 36 to 80 years).Results Procedures were successful in 70 out of 73 cases.There were 18 permanent and 52 temporary IVCFs deployed.The indications for filter insertion were pulmonary embolism (PE) (25 cases,34％),perioperative prophylactic implantation (18 cases,24％),contraindication to anticoagulation therapy (15 cases,20％) and iliofemoral vein thrombosis(10 cases,13％).17 filters were successfully removed with a successful rate of 33％.After the follow-up of mean 24 months (4 to 36 months) of 68 patients,no pulmonary embolism occurred,but symptomatic DVT recurred in 5 patients,and the conditions were improved after anticoagulation treatment.No serious complication of post thrombotic syndrome occurred.Conclusions IVCF placement is effective for prevention of PE,when the therapeutic indications and contraindications are properly controlled.