国产ZQL型可回收式腔静脉滤器的初步临床应用与观察

The home-made retrievable ZQL-type vena caval filter: results of a prospective pilot study

目的 探讨自行开发的可回收式腔静脉滤器 (国产ZQL型可回收式腔静脉滤器 ,以下简称滤器 )预防肺动脉栓塞的临床应用价值。方法 对 2 4例下肢深静脉血栓形成 (deepveinthrombosis,DVT)和 (或 )肺动脉栓塞 (pulmonaryembolism ,PE)的患者经右侧颈内静脉或经健侧股静脉置入滤器 ,并同时行肺动脉造影。术后第 3和第 7天摄腹部平片。术后 3、6、12、18个月摄腹部平片及行下腔静脉、肺动脉造影。如果在 2周内下肢深静脉血栓完全清除 ,则取出滤器 ,取出前摄腹部平片及行下腔静脉、肺动脉造影 ;如果在 2周内下肢深静脉血栓未能完全清除则将滤器长期留置于下腔静脉内。如果随访期间出现病情变化 ,则需随时复查。所有影像资料经 2位主任医师采用盲法进行评价。结果 2 4例患者的下腔静脉滤器均成功置入预定部位 ,其中肾静脉水平以下 2 3例 ,肾静脉水平以上1例 ,2例患者置于肾静脉水平以下的滤器分别于术后第 7天和第 9天顺利取出。中位随访期为 6个月。未发生滤器展开不良、滤器移位 (>10mm)、滤器倾斜 (>10°)、滤器断裂或滤器穿透静脉壁造成血肿等。除 1例腔静脉滤器捕获栓子外 ,未发生滤器血栓形成 ,无下腔静脉闭塞发生 ,随访期内全部患者未再发生肺动脉栓塞。结论 国产滤器置入操作简便、定位准确。

Objective To evaluate the clinical value of the home made retrievable ZQL type vena cava filter for the prevention of pulmonary embolism Methods The filter was implanted via the right jugular vein or the healthy femoral vein in 24 cases of deep vein thrombosis(DVT) with/without pulmonary embolism(PE) At the same time, angiography of pulmonary artery was carried out The abdominal X ray plane graph was obtained on the third and seventh day after the operation On the third, 6th, 12th, and 18th month after operation, abdominal plane graphs and angiography of inferior vena cava and pulmonary artery were obtained If the deep vein thrombosis was cleared out completely in 2 weeks, the filter was retrived after the abdominal plane graph and angiography of the inferior vena cava and pulmonary artery were obtained Otherwise, the filter was retained The patients were asked to be followed up as will All the radiology data of the cases were evaluated by two director physicians by blind way Results All the vena cava filters were implanted successfully in the proper position in the 24 cases(suprarenal inferior vena caval filter in 1 case and infrarenal inferior vena caval filter in 23 cases ) Two filters were retrived on the 7th and 9th day,respectively The mean follow up period was 6 months There were no filter migration (>10 mm )and filter tilting (>10°) There were no filter fracture and no IVC wall penetration There was no filter thrombosis except a filter catching a thrombus There was no obstruction of inferior vena cava and pulmonary embolism Conclusion The implantation of the home made retrievable ZQL type vena cava filter is simple, the orientation is accurate, and the position of the filter can be regulated It is a valuable option for clinical application because of its excellent stability and efficacy