医源性血管腔内异物的处理及预防

目的探讨介入诊疗时预防和处理血管腔内异物的方法。方法15例介入诊疗过程中发生血管腔内异物患者,其中男性6例,女性9例;年龄21～70岁,中位年龄50.6岁。先天性心脏病动脉导管未闭1例;房间隔缺损2例;下腔静脉滤器置入1例;冠心病3例;肾功能衰竭2例;左髂内动脉开口处动脉瘤1例;下腔静脉临时滤器取出1例;经股动脉插管介入诊疗4例。在介入治疗过程中取出异物,并结合文献讨论其预防和处理的方法。结果15例血管腔内异物的患者12例通过介入方法安全取出异物,3例结合外科切开取出,无一例严重并发症发生。结论介入诊疗中,施术者一定要细心,避免粗暴操作,一旦发生血管腔内异物,用介入方法或结合外科手术切开处理是较为理想的方案。

Treatment and prevention of iatrogenic foreign bodies in blood vessels

Objective To investigate the method of treatment and prevention for iatrogenic foreign bodies in blood vessels.Methods A total of 15 patients with intravascular foreign body in the diagnosis and treatment were enrolled,male 6 and female 9,aged 21-70 years old,median age 50.6 years old.One case of all was congenital heart disease and patent ducts arteriosus closed,2 of atrial septal defect;1 of inferior vena filter implantation;3 of coronary heart disease;2 of renal failure;1 of aneurysm in left internal iliac artery openings;1 of inferior vena vein temporary filter removal and 4 of interventional diagnosis and treatment through femoral artery.The foreign body removal in interventional treatment,and the literature of prevention and treatment was discussed.Results For 15 cases of iatrogenic foreign bodies in blood vessels,12 cases were removal security through the intervention methods,3 cases were performed through surgical incision,and no severe complications were occurred.Conclusion It is demonstrated that the surgeon must be careful to avoid rough handling in diagnosis and treatment of intervention,and the interventions or combined with surgical incision is an ideal solution to deal with foreign bodies.