准分子激光辅助回收嵌入型下腔静脉滤器的应用价值

Value of excimer laser-assisted retrieval of embedded inferior vena cava filter

目的探讨下肢深静脉血栓患者采用准分子激光辅助回收嵌入型下腔静脉滤器(IVCF)的效果及安全性。方法2020年10月—2023年3月河南省人民医院诊治下肢深静脉血栓且置入IVCF患者29例,均为嵌入型IVCF,其中行准分子激光辅助回收IVCF者13例为激光组,行球囊扩张辅助回收IVCF者16例为球囊组,记录2组IVCF置入至回收时间、IVCF型号、D-二聚体水平,手术成功率、术中X线透视时间、手术时间、术中疼痛程度、住院时间、术后并发症发生率;随访至2023年6月,记录不良事件发生情况。结果激光组IVCF置入至回收时间[2065(254,3508)d]长于球囊组[61(25,118)d](Z=-4.079,P=0.001),IVCF型号、D-二聚体水平与球囊组比较差异均无统计学意义(P>0.05)。激光组手术成功率(100.0%)高于球囊组(62.5%)(χ^(2)=4.909,P=0.027),术中X线透视时间[13.6(8.4,21.0)min]短于球囊组[32.1(19.6,51.2)min](Z=-2.939,P=0.003),术中重度疼痛比率(0)、术后并发症发生率(0)均低于球囊组(18.8%、31.3%)(χ^(2)=7.431,P=0.038;χ^(2)=4.909,P=0.027),手术时间、住院时间与球囊组比较差异均无统计学意义(P>0.05)。结论准分子激光辅助回收嵌入型IVCF较球囊扩张辅助回收成功率高,术中X线透视时间短、疼痛程度轻,术后并发症发生率低。

Objective To explore the clinical efficacy and safety of excimer laser-assisted retrieval of embedded inferior vena cava filter(IVCF)in patients with lower extremity deep vein thrombosis.Methods In 29 patients with lower extremity deep vein thrombosis undergoing implantaion of IVCF in Henan Provincial People's Hospital from October 2020 to March 2023,13 patients received excimer laser-assisted retrieval of embedded IVCF(laser group)and 16 patients received balloon-assisted retrieval of embedded IVCF(balloon group),and the time from IVCF implantaion to retrieval,IVCF model,D-dimer level,success rate,time of intraoperative fluoroscopy,operative time,degree of pain,length of hospital stay,and rate of postoperative complications were recorded in two groups.The patients were followed up till June,2023 to record the adverse events.Results The time from IVCF implantation to retrieval was longer in laser group[2065(254,3508)d]than that in balloon group[61(25,118)d](Z=-4.079,P=0.001),and there were no significant differences in the IVCF model and D-dimer level between two groups(P>0.05).The success rate was higher in laser group(100.0%)than that in balloon group(62.5%)(x2=4.909,P=0.027),the intraoperative X-ray fluoroscopy time was shorter in laser group[13.6(8.4,21)min]than that in balloon group[32.1(19.6,51.2)min](Z=-2.939,P=0.003),the rates of severe intraoperative pain and postoperative complication rate were lower in laser group(0,0)than those in balloon group(18.8%,31.3%)(x2=7.431,P=0.038;x2=4.909,P=0.027),and there were no significant differences in the operative time and length of hospital stay between two groups(P>0.05).Conclusion Excimer laser-assisted retrieval of embedded IVCF has higher success rate,shorter intraoperative fluoroscopy time,milder degree of intraoperative pain and lower postoperative complication rate than balloon-assisted retrieval of embedded IVCF.