腔静脉滤器在老年下肢深静脉血栓患者治疗中的应用

目的探讨腔静脉滤器在老年下肢深静脉血栓患者治疗中的应用。方法选择77例急性下肢深静脉血栓患者,将年龄≥60岁的48例为老年组,年龄60岁的29例为非老年组,2组均置入腔静脉滤器,术后采用接触性导管溶栓23例,外周血管溶栓54例,以治疗3 d后患肢膝关节上15 cm周径较治疗前的变化判断疗效。结果全部患者顺利置入腔静脉滤器,技术成功率100%。术后无肺动脉栓塞发生。与治疗前比较,老年组和非老年组治疗后患肢膝关节上15 cm周径明显下降(P0.05),但2组治疗前后膝关节上15 cm周径变化差值无明显差异(P=0.324)。接触性导管溶栓较外周血管溶栓治疗效果更佳(P=0.000)。1例成功取出腔静脉滤器,13例次出现抗凝过度情况。结论腔静脉滤器及温和的溶栓治疗,可以有效防止老年患者肺动脉栓塞的发生,安全性高。

Application of vena cava filter in elderly patients with lower extremity deep venous thrombosis

Objective To evaluate the vena cava filter implantation therapy for deep venous thrombosis in elderly patients.Methods Seventy-seven patients were divided into two groups:senile group(48 cases) and non-senile group(29 cases).All received implantation of inferior vena cava filter(IVCF).Anti-coagulation and thrombolytic treatment were given.Results All vena cava filters were applied successfully and no pulmonary embolism occurred.The difference of treatment effect in two groups had no statistical significance (P = 0.324).Twenty-three patients receiving catheter-directed thrombolysis showed better outcomes than those receiving peripheral blood vessel thrombolysis (P = 0.000).IVCF was removed from 1 patient after treatment.Thirteen casetimes showed excessive anti-coagulation phenomenon.Conclutions The vena cava filter implantation and moderate thrombolysis treatment can prevent the occurrence of pulmonary embolism in elderly patients effectively and safely.