下腔静脉滤器在下肢深静脉血栓治疗中的临床应用

【关键词】  腔静脉滤器;腔静脉,下;深静脉血栓形成;肺栓塞

　　［摘要］目的 探讨下腔静脉滤器植入在下肢深静脉血栓治疗中预防肺动脉栓塞的应用价值。方法 30例下肢深静脉血栓形成的病人，14例植入永久性腔静脉滤器，16例植入临时性腔静脉滤器;27例分别行单纯静脉溶栓或切开取栓+静脉置管溶栓;全部病例同时行抗凝治疗。结果 下腔静脉滤器植入全部成功，症状体征完全消失7例，明显缓解18例，部分缓解5例。滤器植入期间未发生肺栓塞。临时滤器在体内留置时间26～40 d，1例取出后2 d出现复发性肺栓塞;2例永久性滤器植入者于6个月和14个月出现下腔静脉堵塞。结论 下腔静脉滤器植入术是一种安全、有效预防肺动脉栓塞发生的临床措施，临时性和永久性滤器各有优缺点。

　　［关键词］ 腔静脉滤器;腔静脉，下;深静脉血栓形成;肺栓塞

　　CLINICAL APPLICATION OF VENA CAVA FILTER FOR DEEP-VEIN THROMBOSIS OF THE LOWER EXTREMITY

　　LI ZI-XIANG， WANG HAO-FU， SUN CHENG-JIAN， et al

　　（Department of Interventional Radiology， The Affiliated Hospital of Qingdao University Medical College， Qingdao 266003， China）

　　［ABSTRACT］ObjectiveTo assess the clinical value of vena caval filters in the prevention of pulmonary embolism （PE） in patients with deep-vein thrombosis （DVT）. MethodsThe implantation of vena caval filter was performed in 30 patients with DVT of lower extremities. A permanent filter was used in 14 cases， and temporary filter in 16. Of the 30 cases， 27 received venous thrombolysis or thrombectomy combined with interventional thrombolytic therapy. ResultsAll the filters were successfully in-serted. Symptoms and signs completely disappeared in seven patients， remarkably recovered in 18 and partly recovered in five. No PE was documented during filter implantation. Temporary filters detained in vena cava for 26-40 days. One patient had recurrent PE two days after removal of the filter. Two patients with permanent filter presented inferior vana caval occlusion at six and 14 months， respectively. Conclusion Implantation of inferior vana caval filter is safe and effective in the prevention of PE. Perma-nent or temporary filter has its advantages and disadvantages.

　　［KEY WORDS］vena caval filters; vena cava， inferior; deep-vein thrombosis; pulmonary embolism

　　深静脉血栓（DVT），尤其是下肢静脉血栓为临床常见病，血栓脱落可产生肺动脉栓塞（PE），大的血栓脱落可导致肺动脉主要分支阻塞而危及生命。植入下腔静脉滤器已被证明是一种安全

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