上腔静脉滤器置入预防肺动脉栓塞的探讨研究

A Study of Superior Vena Cava Filter Placement to Prevent Pulmonary Embolism for Patients with Upper Extremity Deep Thrombosis

目的探讨上腔静脉滤器置入预防上肢深静脉血栓形成发生肺栓塞的安全性、可行性、有效性。方法回顾性分析中南大学湘雅医院及中国人民解放军第163医院从2011年1月至2015年6月收治的42例急性上肢深静脉血栓形成患者的临床资料。其中2011年1月至2013年7月收治的23例患者未行上腔静脉滤器置入术,归为Ⅰ组;2013年8月至2015年6月收治的19例患者行上腔静脉滤器置入术,归为Ⅱ组。结果Ⅰ组有5例(21.7%)发生肺栓塞死亡,Ⅱ组中无肺栓塞发生,两组比较差异显著(P=0.030)。Ⅱ组1例术后发生滤器向近心端方向移位1 cm,绝对卧床后滤器未继续移位;无其它并发症发生,所有滤器溶栓结束后成功拔出。结论上腔静脉滤器是预防急性上肢深静脉血栓形成发生肺栓塞的可靠方法。

Objective To explore the safety,efficacy,and feasibility for superior vena cava filter placement to prevent pulmonary embolism for patients with upper extremity deep thrombosis. Methods42 clinical data of patients with acute upper extremity deep thrombosis in Xiangya Hospital and the No. 163 Hospital of PLA. from January 2 0 1 1 to June 2 0 1 5 were retrospectively analyzed. The patients were divided into two groups according to the superior vena cava filter placement or not. Group Ⅰ was consisted of 2 3 cases without superior vena cava filter from January 2 0 1 1 to July 2 0 1 3. Group Ⅱ was consisted of1 9 cases with superior vena cava filter from august 2 0 1 3 to June 2 0 1 5. Results 5 cases died of pulmonary embolism in group Ⅰ. There was no pulmonary embolism or death in group Ⅱ. The difference was significant（ P = 0. 030）. One patient suffereal from the migration of filter which was stopped by strict inbed-stay. And all the filters were pulled out successfully. Conclusion It is a reliable method of superior vena cava filter placement to prevent pulmonary embolism.