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目的　回顾性分析在深静脉血栓(DVT)病人中植入腔静脉滤器预防致死性肺动脉栓塞发生的有效性。方法　1998～2 0 0 4年,北京铁路总医院共为70例DVT病人植入腔静脉滤器。其中5 9例在滤器植入前进行肺部检查,CT血管成像(CTA) 4 0例,同位素肺血流灌注显像(LPS) 2 4例,彩色心超检查14例,肺动脉造影4例。结果　全部70例病人中,5 3例在滤器植入前被诊断为肺动脉栓塞。其中有11例有相应的临床症状,2例出现呼吸心跳骤停,经积极抢救得以复苏,10例因某些原因不能进行有效抗凝和溶栓治疗,7例主动要求植入滤器。6 0例随访至今,未发生致死性肺动脉栓塞,2例病人术后出现健侧肢体静脉血栓,3例病人1年后腔静脉因血栓机化而闭塞。结论　对于DVT病人,科学正确的选择腔静脉滤器植入能有效预防致死性肺动脉栓塞的发生。

Transplanting vena caval filter for the prevention of fatal pulmonary embolism: an analysis of 70 cases

Objective To analysis the effect of transplanting vena caval filter in patients with deep venous thrombosis(DVT) retrospectively.Methods From 1998 to 2004,70 patients with DVT were transplanted the vena caval filter in Beijing General Railway Hospital.The examinations of pulmonary embolism were performed in 59 cases before the transplantation of vena caval filter.Among 59 patients,40 cases were examined by CTA.Twenty-four cases were examined by lung perfusion scanning(LPS).Fourteen cases were examined by color contrast echocardiography.Four cases were examined by venography.Results In 70 cases,53 cases were diagnosed as the pulmonary embolism.Among them,11 cases had symptoms of pulmonary embolism.Fatal pulmonary embolism was present in 2 cases.In 70 cases,10 cases couldn't be treated by anticogulation and thromboclasis effectively for save reasons and 7 cases asked for the transplantation of vena caval filter initiatively.Sixty cases were followed up.No fatal pulmonary embolism occurred.The new DVT was present in 2 patients after the transplantation of vena caval filter and 3 patients were developed obstruction in Vena caval after one year.Conclusion Fatal pulmonary embolism can be prevented by transplanting the Vena caval filter correctly and sciencely for patients with DVT.