下腔静脉滤器植入联合抗凝治疗下肢深静脉血栓形成临床应用

Clinical practice of inferior vena cava filter placement combined with anticoagulant therapy treating deep venous thrombosis of lower extremity

目的 观察并评价下腔静脉滤器植入联合抗凝治疗下肢深静脉血栓形成的临床应用价值.方法 对我院2001年2月至2010年6月期间收治的37例下肢深静脉血栓形成患者应用溶栓、抗凝结合静脉滤器置入治疗,测量、记录所有患者治疗前及治疗后1～3个月患侧、健侧小腿中部及大腿中部、大腿根部周径,判断疗效.结果 37例下腔静脉滤器均成功植入,大部分患肢1周内血液回流均明显改善,症状减轻,总有效率为94.6％ （35/37）；患者治疗前后小腿中部、大腿中部、大腿根部患侧与健侧周径差的差异有统计学意义[分别为：（4.6±2.4）cm比（1.8±1.4）cm,（5.3±2.5）cm比（1.4±1.0）cm,（5.5±2.3）cm比（1.5±1.6）cm,均P＜O.05].术后1～6个月随访,均未出现肺栓塞症状.结论 下腔静脉滤器植入联合抗凝治疗下肢深静脉血栓形成操作简单,可以明显改善患者下肢血液回流,并有效预防肺动脉栓塞的发生.

Objective To investigate the clinical effect of inferior vena cava filter placement combined with anticoagulant therapy in deep venous thrombosis （DVT） of lower extremity. Methods All 37 patients diagnosed of DVT in lower extremity from february 2001 to June 2010 were treated with thrombolysis, anticoagulation and inferior vena cava filter placement. The therapeutic effects were observed by comparing the circumference changes of calves and thighs before and after treatment. Results Inferior vena eava filters were successfully implanted in all patients and the blood flow recoveries and symptoms were significantly improved within 1 week, and total effective rate was 94.6% （35/37）. There were significant differences in circumference changes of the limbs before and after treatment [（4.6±2.4）emvs （1.8±1.4）cm,（5.3±2.5）cmvs （1.4＋1.0）cm,（5.5±2.3）cmvs （1.5±1.6）cm,all P 〈 0.05 ]. Pulmonary embolism were not observed during 6 months follow-up in all cases. Conclusion It is a simple method to improve the blood flows of lower extremity and avoid the occurrences of pulmonary embolism in DVT patients by inferior vena cava filter implantation combined with anticoagulant therapy.