抗凝治疗对永久性下腔静脉滤器置入术后滤器通畅率的影响

Efficacy of anticoagulation on patency post-permanent inferior vena cavai filter placements

目的研究抗凝治疗对永久性下腔静脉滤器黄入术后滤器通畅率的影响。方法回顾性分析2001年12月至2007年12月138例因下肢深静脉血栓形成置入永久性下腔静脉滤器的患者。男性75例，女性63例，平均年龄65岁。随访其口服华法林时间和下腔静脉滤器的通畅状况。按口服华法林的长短分为未抗凝组（n=41）、抗凝A组（口服华法林≤6个月，n=20）和抗凝B组（口服华法林〉6个月，n=77）。X^2检验比较各组患者的滤器闭塞率，Kaplan-Meier生存分析比较各组的平均滤器通畅时间和1、3年滤器累计通畅率，Log-rank法进行显著性检验。结果本研究死亡16例，其中1例患者死于肺栓塞。确定为终点事件者为19例（13．8％）。未抗凝组、抗凝A组和抗凝B组之间滤器通畅率（87．8％、75．0％和88．3％）差异无统计学意义（P=0．288）。三组滤器通畅时间和1、3年的滤器累计通畅率（87．1％、80．0％、94．8％和87．1％、74．3％、85．4％）差异亦无统计学意义（P=0．227）.结论抗凝治疗对滤器晋入术后滤器涌畅率的根高沿右明显影响．

Objective To discuss the efficacy of anticoagulation on patency post-permanent inferior vena caval filter （IVCF） placements. Methods The patients with deep vein thrombosis （DVT） of the lower extremity who were accepted permanent IVCF placement from December 2001 to December 2007 were reviewed retrospectively. Data on vital status, filter thromboembolism, anticoagulation time, and so on were obtained through follow-up. One hundred and thirty eight patients （75 male and 63 female） with a mean age of 65 years were enrolled in the study. All the patients were divided into non-anticoagulation group, anticoagulation group A with taking warfarin less than 6 months, or anticoagulation group B with taking warfarin more than 6 months.X^2 test, t test, Kaplan-Meier survival curve, Log-rank test were used for statistics analysis. Results Sixteen patients died, and 1 of them died of pulmonary embolism. Including the 1 patient mentioned before, there were 19 patients （ 13.8% ） suffered from filter thromboembolism. Upon X^2 test, there were no significant differences （P = 0. 288） on the patency rates between non-anticoagulation,anticoagulation group A and anticoagulation group B （87.8%, 75.0% , and 88.3% respectively）. Upon Kaplan-Meier survival analysis, there were still no significant differences （P =0. 227） on the mean patency time and the cumulate rates of patency at the 1st or 3rd year between the 3 groups （87. 1%, 80. 0% , 94. 8% and 87. 1%, 74. 3%, 85.4% respectively）. Conclusion Anticoagulation has no efficacy on patency post-permannet IVCF placements.