Gunther Tulip下腔静脉滤器置入术的临床应用

Clinical application of the Gunther Tulip inferior vena cava filter

目的:评价GuntherTulip下腔静脉滤器置入术对预防肺栓塞(PE)的效果及使用中的问题。方法:对16例下肢深静脉血栓形成患者实施经皮股静脉穿刺GuntherTulip下腔静脉滤器置入术,术后立即行下腔静脉(IVC)造影及术后1,3,6,12个月分别摄腹部平片或做滤器处彩超,观察滤器位置、形态及有无并发症。结果:16例均经股静脉成功置入滤器于肾静脉下方1·16±1·21cm的IVC内,3例滤器释放瞬间有一向前弹性冲力,但滤器前跳均<0·5cm。1例经左股静脉置入滤器倾斜度>15°,无扩展不良。复查时均未发现滤器移位及PE发生。结论:GuntherTulip下腔静脉滤器置入术对预防肺栓塞是一种操作简便、安全、有效的方法,其可取出体外的特点而具有广阔的应用前景。

Objective：To preliminary evaluate the efficacy and problems of percutaneons insertion of the Gunther Tulip inferior vena cava filter （GTF） for the prevention of pulmonary embolism （PE）. Methods： GTF was inserted in 16 cases of deep venous thrombosis （DVT） from femoral vein. The inferior venacavogram were performed immediately and 1,3,6,12 month after operation abdominal radiograph or duplex sonography of the inferior vena cava were taken respectively for inspection the position and shape of the filter and complications. Results： GTF was inserted successfully in 16 cases from the femoral vein. The filter were implanted into the infrarenal inferior vena cava with the apex of the filter below the lowest renal vein 1.16 ± 1.21cm. The elastic strength to proximal in the moment of releasing were found in three cases. GTF have a tendency to tilt more than 15° in one from left femoral approach. All cases were followed up for 3 - 24 months without migration of filters and PE finding. Conclusion： The GTF implantation is a safe and effective method to prevent PE . feature of retrievable has a broad range of utility in prevention of PE.