某三甲医院下腔静脉滤器安置与未回收患者5年回顾性分析

5-year retrospective analysis on patients with inferior vena cava filter indwelling and non-recycle in a class 3A hospital

目的了解某三甲医院连续5年下腔静脉滤器(IVCF)的安置与回收情况,并分析滤器未回收的原因。方法回顾性分析2012-2016年806例安置IVCF患者的临床资料,包括一般资料、血栓分型、滤器类型、放置原因、回收现状等,对未回收滤器的患者进行随访,分析滤器未回收的原因。结果深静脉血栓(DVT)患者滤器置入率为26.84%(806/3003);滤器的类型:可回收型96.28%、临时型0.87%、永久型2.85%;滤器回收率22.21%,回收时间(13.65±4.19)d,不同年龄分层、不同疾病患者滤器回收率差异有统计学意义(P<0.01);滤器未回收的原因前5位是:再次肺栓塞风险(40.72%)、年龄偏大(34.54%)、发生并发症无法回收(20.88%)、经济困难(13.66%)、合并肿瘤(12.11%);86.08%(334/388)的患者并不知晓未回收IVCF的危害。结论滤器低回收率与患者年龄、合并恶性肿瘤、发生并发症等因素相关。医务人员应审慎地评估长期留置滤器的获益与风险,提高滤器回收率,同时需加强对长期留置滤器患者的随访,防范远期并发症发生。

Objective To understand the indwelling and recycle of inferior vena cava filter(IVCF),and to analyze the reasons of filter non-recycle in a class 3A hospital during 5 consecutive years. Methods The clinical data in 896 cases of IVCF indwelling were retrospectively analyzed,including the general data,thrombus classification,filter type,indwelling reason,recycling status,etc.The patients with non-recycle filters conducted follow-up.The reasons of filter non-recycle were analyzed. Results The filter indwelling rate in the patients with DVT was 26.84%(806/3 003),the filter types:retrievable type 96.28%,temporary type 0.87 % and permanent type 2.85%;the filter recycle rate was 22.21%,the recycle time was (13.65 ± 4.19)d,the filter recycle rate had statistical difference among different age stratification and whether suffering from malignant tumor ( P <0.01):the top 5 places for the filter non-recycle reasons:risk of pulmonary embolism again (40.72%),older age (34.54%),can not recycle due to complication occurrence (20.88%),economic difficulty (13.66%) and complicating tumor (12.11%);86.08%(334/388)of the patients did not know the hazard of IVCF non-recycle. Conclusion The low recycle rate of filters is correlated with the factors of patient′s age,complicating malignant tumor and complications occurrence.Medical staffs should carefully assess the benefit and risk of long-term indwelling filter,increase the filter recycle rate,at the same time,it needs to strengthen the follow-up of the patients with long-term indwelling filter and prevent the occurrence of long-term complications.