山东半岛成人肾下下腔静脉直径与长度测量及其意义

Diameter and length measurement of infrarenal inferior vena cava in Shandong Peninsula adult and its significance

目的 利用数字减影血管造影（DSA）测量肾下下腔静脉的直径及长度,定位肾静脉位置,更好地指导下腔静脉滤器类型选择与准确置放.方法 选择2008年4月至2010年6月因下肢深静脉血栓形成行下腔静脉滤器置放的83例患者,男性49例,女性34例,平均年龄56.4岁.滤器置放指征均参考ACCP-8标准.于放置滤器前行下腔静脉造影,通过DSA自带软件测量肾下下腔静脉直径及长度,同时确认肾静脉开口的位置及下腔静脉的形态,根据上述结果选择不同的滤器.结果 根据造影结果选择合适滤器,所有滤器释放位置良好,无覆盖肾静脉情况发生.肾下下腔静脉直径10～26 mm,平均（19±5）mm,无直径＞28 mm的巨大下腔静脉.肾下段下腔静脉长度平均为（10.6±2.8）cm.肾静脉位于L1-2之间,髂静脉分叉位于L4-5腰椎之间.结论 肾下下腔静脉直径与长度的测量对于指导滤器类型的选择及国产滤器的研发有较大作用,下腔静脉造影对腔静脉滤器的精确置放有重要的指导意义.

Objective To measure the diameter and length of infrarenal inferior vena cava （IVC）in Shandong Peninsula adult through digital subtraction angiography （ DSA） for better vena cava filter （VCF） choice and placement. Methods From April 2008 to June 2010, 83 discontinuous patients （49 males and 34 females, mean age 56. 4 years） with deep venous thrombosis （ DVT） of lower extremity were placed VCF through DSA according to ACCP-8. During operation, diameter and length of infrarenal IVC were measured. At the same time, the renal vein location and the type of the IVC were identified to help the VCF choice. Results All the VCFs were placed successfully, no complications occurred. The diameter of infrarenal IVC was 10 to 26 mm with a mean of （19 ±5） mm. The average length from beginning of IVC to the lower renal vein was （10. 6 ±2. 8） cm. The renal vein was located between the first and second lumbar vertebra, the IVC beginning was located between the fourth and fifth lumbar vertebra. Conclusions Diameter and length measurement of infrarenal IVC is helpful to the VCF selection and the domestic VCF research. Vena cava angiography is very important to the accurate placement of VCF.