下腔静脉滤器置入术预防肺动脉栓塞79例分析

Prevention of Pulmonary Artery Embolism by Placement of Inferior vena Filter(analysis of 79 cases)

目的：探讨经皮穿刺下腔静脉滤器（VCF）置入术预防肺动脉栓塞（PE）在下肢深静脉血栓（DVT）治疗中的作用。方法：自2008年1月~2010年4月,对79例下肢深静脉血栓患者施行下腔静脉滤器置入术,其中临时性滤器6例,永久性滤器73例,男性35例,女性47例;年龄22~85岁,平均51.4岁。深静脉血栓位于右下肢16例,左下肢57例,双下肢4例,下腔静脉2例。经健侧股静脉路径滤器置入73例,经颈静脉路径置入6例。常规行下腔静脉造影,将滤器置入到肾静脉开口水平下的下腔静脉。结果：本组病例全部释放成功。出院前均行腹部X线片检查滤器位置和形态。术后随访2~25个月,均无肺栓塞发生。结论：经皮穿刺下腔静脉滤器置入术操作简便,能有效预防下肢深静脉血栓患者发生肺动脉栓塞,并防止再发肺栓塞所致死亡。

Objective：The aim of this study was to evaluate the effect of percutaneous placement of inferior vena cava filter（VCF） to prevent pulmonary embolism（PE） in the treatment of deep venous thrombosis（DVT） of lower limbs.Method： Since Jan 2008 to April 2010,we placed the VCF,6 temporary filters and 73 permanent ones,in 79 patients of DVT of lower limbs,there were 35 males and 47 females,aged between 22 and 85（mean age was 51.4）.DVT in 16 patients were located in the right lower limb,57 in the left lower limb,4 in both limbs,and 2 in the inferior vena cava（IVC）.In 73 cases the transfemoral placement of inferior vena cava filter in the intact limb were performed,and in 6 cases chose the transjugular route.Following the routine IVC fluoroscopic guidance the filter is inserted into the IVC,and located just below the junction of the IVC and the renal vein.Result： The deployment were succeed in all cases.Before the discharge,abdominal radiography was performed to examine the location and shape of the filter in the patient.During the 2 to 25 months＇ follow-up after the surgery,no PE was recorded.Conclusion： The percutaneous placement of inferior vena cava filter was a easy procedure,it could effectively precluded PE in patients of DVT of lower limbs and thus the death caused by PE.