腔静脉滤器对妇产科病人肺栓塞的预防价值

目的:研究永久和临时腔静脉滤器运用于妇产科病人对肺栓塞的预防效果、并发症。方法:33例病人安放VTF(Vena Tech-LGM filter,VTF)永久滤器23支;安放FRF02临时滤器(Filter RF02,FRF02)11支(其中1例,安放永久和临时滤器各1只)。永久滤器随访期(3~57)月,平均22月,临时滤器平均置入4.9天。随访有无发生或再发肺栓塞,复查腹部平片,做滤器处彩超和CT检查。结果:复查病例6.7%(1/15)的VTF发生移位,6.7%(1/15)的VTF内有血栓。安放永久滤器病例,1例再发肺栓塞。安放临时滤器病例,发生穿刺部位血肿1例,取出滤器上附有血栓3例,未发生肺栓塞。结论:对于合并静脉血栓性疾病的妇产科病人,使用永久和临时滤器,安全性高,对肺栓塞有良好的预防作用。

Inferior vena cava filters as a prophylaxis of pulmonary embolism in obstetrics and gynecology

Objective:Retrospective review of indications, safety and effectivness of permanent and temporary vena cava filter in obstetrics and gynecology.Methods:Between January 1995 and December 2006,23 VTF(Vena Tech-LGM filter,VTF) and 11 temporary FRF 02(Filter RF 02,FRF02)were placed in 33 patients from obstetrics and gynecology(both temporary and permanent filter were inserted in one patient).The follow-up examinations were performed by color-coded duplex sonography,plain radiographs and computer tomography(CT). The mean observation time was 22 months by permanent and 4.9 days by temporary vena cava filter.Results:Filter migration occurred in 6.7%(1/15) of the VTF.Vena cava thrombosis was seen in 6.7(1/15) of the follow-up patients with a VTF. Pulmonary embolism was only noted in 1 patient after VTF insertion.Complication of the temporary FRF 02 included a hematom at the puncture site in one patient and residual thrombi on the filter after its removal in 3 patient.Conclusion:The results support that vena cava filter placement in patients with venous thromboembolism from obstetrics and gynecology is a safe and effective prophylactic method.