下腔静脉阻隔术及置网术预防肺栓塞44例临床分析

Inferior vena cava partial interruption and filter placement in the prevention of pulmonary embolism: experience of 44 cases

目的总结下腔静脉 (IVC)阻隔术及置网术预防下肢深静脉血栓 (LEDVT)继发肺栓塞的临床经验。方法回顾性分析LEDVT 44例的临床资料 ,其中接受IVC阻隔术者 10例 ,IVC置网术者 34例。评估手术死亡率、肺栓塞复发率及LEDVT脱落情况。结果IVC阻隔术组 (10例 )术后肺栓塞症状好转者 7例 ,围手术期无死亡或严重并发症 ,术后随访 6例 3月至 1年 ,无死亡 ,3例出现非致命性肺栓塞。所有病例下肢症状均无明显变化。置网术组 (34例 )术后肺栓塞症状好转者 2 4例 ,下肢症状好转者 2 6例 ,住院期间 2例发生肺栓塞 ,1例死亡。 2 0例平均随访 10月 ,无肺栓塞复发。结论IVC阻隔术与置网术均是安全有效的手术方式。

ObjectiveTo evaluate partial inferior vena cava (IVC) interruption and filter placement in the prevention of pulmonary embolism caused by lower extremity deep vein thrombosis (LEDVT).MethodsAmong 44 cases of LEDVT, 10 cases underwent partial IVC interruption, 34 cases received IVC filter placement.Results7 out of 10 cases undergoing IVC occlusion experienced post operative relief of non-fatal pulmonary embolism symptoms with no perioperative mortality or severe complications.On follow-up of 8 months, 3 cases experienced non-lethal pulmonary embolism. 24 out of 34 filter placement cases had postoperative relief of pulmonary embolism symptoms with no perioperative mortality. 2 cases suffered from inhospital pulmonary embolism with one death. 20 cases were followed up for an average of 10 months without recurrence of pulmonary embolism. Conclusion Both partial IVC interruption and filter placement are safe and effective surgical procedures for the prevention of recurrence of pulmonary embolism. The result of filter placement is more favourable.