下腔静脉滤器在下肢深静脉血栓治疗中的应用

Clinical application of inferior vena cava filter in the treatment of deep venous thrombosis of lower extremity

目的 探讨下肢深静脉血栓形成患者置入下腔静脉滤器预防肺栓塞的作用。方法 5 5例下肢深静脉血栓患者治疗前置入下腔静脉滤器 ,其中SimonNitiol滤器 (SNF ) 2 5例 ,TrapEase滤器(TEF ) 13例 ,AntheorTemporal滤器 (ATF) 17例。 10例采用抗凝溶栓治疗 ,45例实施手术和腔内治疗 ,临床观察有无出现肺栓塞症状和体症 ,定期透视SNF和TEF的形态与位置。结果 下腔静脉滤器置入全部成功 ,经治疗下肢深静脉血栓症状及体征消失 ,无肺栓塞发生。 1例置入SNF 16个月 ,出现下腔静脉阻塞。 17例临时性置放滤器者ATF取出后发现有血栓性物质。结论 腔静脉滤器近期预防肺动脉栓塞简便安全有效 ,远期并发症要引起重视 ,并待进一步研究。

Objective To investigate the protection effect of inferior vena cava filter on pulmonary embolism in patients with deep venous thrombosis(DVT) of lower extremities. Methods Inferior vena cava filters were placed in 55 patients with DVT. Simon Nitiol filter(SNF) was used in 25 cases,Trap Ease filter(TEF) in 13 cases and Antheor Temporal filter(ATF) in 17 cases.10 patients with DVT were treated by non operation therapy,45 patients by operation and transluminal angioplasties.Whether patients occurred pulmonary embolism was observed clinically,and the form and site of SNF and TEF were monitored by periodic fluoroscopy . Results Inferior vena cava filter was placed successfully in all patients.Symptoms and signs of DVT disappeared in all the patients after treatment . None of the putients occurred pulmonary embolism in this series. One case occurred inferior vena cava thrombolism in 16 months after SNF placement. Thrombus attached to ATF after the ATF taking off from inferior vena cava was found in 17 cases.Conclusions Inferior vena cava filter placement is a simple, safe and efficient method to prevent pulmonary embolism in a short period.But its long term complications should be considered and investigated.