可回收下腔静脉滤器在DVT治疗中的应用

Retrievable inferior vena cava filter for deep venous thrombosis

目的探讨临时性下腔静脉滤器在下肢深静脉血栓(DVT)治疗中的应用。方法对28例下肢深静脉血栓(DVT)患者的临床资料进行回顾性分析。采用Seldinger技术穿刺健侧股静脉,先行下腔静脉造影,明确下腔静脉管径、有无血栓及肾静脉开口位置,换导引长鞘,将滤器送入距肾静脉下缘1.5cm处释放,再次造影,证实滤器准确无误,拔管局部加压包扎,术后抗凝治疗。除1例外,其余病例均于14～22d经原路径应用抓捕器取出下腔静脉滤器。结果 27枚滤器取出。在滤器上均可见多少不等的血栓;1例置入15d时滤器被大量血栓阻塞,经手术取栓后,置溶栓导管溶栓,好转,未取滤器。无肺栓塞发生。结论应用临时性滤器可以有效的防止肺栓塞的发生。

Objective To study the clinical application of retrieval inferior vena cava filter （IVCF） for deep venous thrombosis （DVT） of lower extremities.Methods A retrospective analysis of clinical data of 28 patients with DVT undergoing IVCF implantation was made. Appling Seldinger technique,28 filters were inserted in inferior vena cava below the renal veins.Anticoagulation therapy was given after operation. The IVCF was taken out after 14-22 days except 1.Results Twenty-seven IVCFs were taken out via femoral venous access.Some blood clot was found in all the filters. One filter was fully blocked by blood clot following venous thrombolysis, but it resolved on thrombolytic therapy. so the filter was not removed. No pulmonary embolism（PE） occurred.Conclusions The use of temporary filter in cases of deep venous thrombosis can effectively prevent the development of pulmonary embolism.