彩色超声引导下腔静脉滤器置入术

Inferior vena cava filter placement guided by color-ultrasonography

目的 报道超声引导下腔静脉滤器置入新方式及其对深静脉血栓后肺栓塞的预防作用。 方法 自 2 0 0 2年 5月～ 2 0 0 3年 1月对 9例下肢深静脉血栓形成 (其中 1例入院时出现肺栓塞 )在彩色超声引导下实施下腔静脉滤器置入术 ,其中5例在滤器置入术后立即实施下肢深静脉取栓术 ,另外 4例行保守治疗。 结果 本组 9例均获成功 ,随访 1月～ 7月 ,平均 2月 ,无并发症及肺栓塞发生 ,曾出现肺栓塞者滤器置入后未再发生肺栓塞。 结论 彩色超声引导下腔静脉滤器置入术可有效地预防深静脉血栓形成后肺栓塞的发生 ,对不易搬动、危重、肾功能不全和对造影剂过敏的患者是最佳的选择 ,免除了X射线的辐射 ,安全、方便、经济、易于普及。

Objective To report an improved method, color-ultrasonography-guided inferior vena cava (IVC) filter placement, for preventing the pulmonary embolism (PE) caused by the deep venous thrombosis (DVT). Methods Color-ultrasonography-guided IVC filter insertion was performed in 9 patients with DVT of lower limb, 1 of which also had PE accompanied with at the time of admission. Out of the 9 patients, 5 patients underwent embolectomy immediately after the filter placement while the other 4 patients were treated conservatively. Results The placements were all completed successfully. Follow-up observations for 1～7 months (mean 2 months) found no complications or occurrence of PE. No recurrence of PE was found in the patient already with PE. Conclusions The color-ultrasonography-guided IVC filter placement can effectively prevent PE caused by DVT. The method is suitable for severe, immovable patients, as well as patients with renal insufficiency and being allergic to intravenous contrast, and is safe, convenient, cheap and prone to popularization.