永久性下腔静脉滤器(TrapEase)在下肢深静脉血栓综合治疗中的临床意义

Clinical evaluation of permanent inferior vena cava filter (TrapEase) in the treatment of deep vein thrombosis of lower limb

目的探讨永久性下腔静脉滤器在综合治疗下肢深静脉血栓形成中的应用价值。方法选取笔者所在医院2003年11月～2008年9月明确诊断下肢深静脉血栓患者76例,其中男性54例,女性22例,年龄28～78岁,平均年龄54.26岁。深静脉血栓位于左下肢45例,右下肢23例,双下肢8例。所有患者均在放置下腔静脉滤器后,留置导管进行溶栓抗凝治疗。结果所有患者均一次性放置滤器成功,除6例患者出现皮下血肿外无其他并发症出现。76例患者治愈51例(67.11%),显效18例(23.68%),共69例患者溶栓治疗效果满意(90.79%)。随访1～18个月,无一例出现滤器移位或肺栓塞。有13例患者下肢静脉血栓复发,复发时间2～12个月,平均7.2个月。结论下腔静脉滤器置入后置管溶栓是治疗下肢深静脉血栓形成的一种安全有效的方法,可以有效降低下肢深静脉血栓形成所致肺栓塞的发生。

Objective To assess the significance of permanent inferior vena cava filter （IVCF） in the treatment of lower limb deep vein thrombosis（DVT）. Methods From November 2003 to September 2008, 76 cases with lower limb DVT （male 54 and female 22, aged 28 - 78 years, mean age 54.26 years） were treated with implantation filter in inferior vena cava. In these patients there were 45 cases with the embolism in left leg, 23 cases in right leg and 8 cases in both legs. All the cases were treated with catheter directed thrombolytic and anticoagulant therapy. Results All the 76 patients were implanted IVCF successfully, no complications occurred except echymoma in 6 patients. Fifty-one cases were cured （67.11%）, 18 cases had excellence result （23.68 %） and all of above patients（90.79 %） were satisfied with the results. Neither filter migration nor pulmonary embolism was found in the patients during 1 - 18 months follow-up. Only 13 patients had recurrence of DVT from 2nd to 12th month after treatment. Conclusion Application of IVCF combined with thrombolytic and anticoagulant therapy is a safe and effective approach in patients with DVT, and it can also prevent from fatal PE due to DVT.