腔静脉滤器置放的适应证研究

目的进一步探讨置放腔静脉滤器（VCF）的适应证。材料和方法本研究对47例根据临床表现、下肢深静脉彩色多普勒超声检查和下肢静脉造影诊断为下肢深静脉血栓形成（DVT）而未置放VCF的患者,其完整病例进行回顾性分析,其中男20例,女27例,年龄24～76岁,平均53岁。通过回顾性分析相关病例资料、病程转归,复习经胸超声心动图、血浆肌钙蛋白I（cTnI）检查,分析其与早期死亡的相关性,从而进一步探讨置放VCF的适应证。数据的分析与处理采用SPSS11.0统计软件。结果①34例未给予VCF置放的DVT患者行经胸超声心动图检查测量其肺动脉压：肺动脉压增高与死亡显著相关（P〈0.01）,有统计学意义。②31例未行VCF置放DVT患者行肌钙蛋白I（cTnI）检查：血浆cTnI阳性组其死亡率增高（P〈0.01）,有统计学意义。结论对高危DVT患者置放VCF可预防致死性肺栓塞（PE）发生,并可及时、安全地进行溶栓、抗凝等综合治疗,对于减少死亡率、降低后遗症有重要意义。严格选择VCF适应证除根据临床表现、影像学资料外,还可结合某些辅助检查如肺动脉压、血浆肌钙蛋白I（cTnI）等做为参考依据。

The study of indication of placing vena cava filter in patients

Objective To discussion indication of placing Vena Cava Filter （VCF） further. Methods We research 47 Deep Venous Thrombosis （DVT） patients without VCF,which diagnosed by clinical manifestation,Color Doppler Ultrasonography of deep vein and contrast diagnosis with retrospective analysis,which include 20 men,27 women,24~76 years old,and the average age is 53 years. we analysised the case information by echocardiography through chest、cTnI. We adopt Statistical Software SPSS11.0. Results ①The 34 DVT patients without VCF indicated with pulmonary artery pressure that there were obviously correlated between death and Pulmonary Hypertension （P〈0.01）,and which is statistical significant. ③Examining of CTnI of the 31 DVT patients without VCF indicated that the mortality of the patients was increase if cTnI positive,and which is statistical significant （P〈0.01）. Conclusion VCF placement is an effective method in the prevention of pulmonary embolism after deep vein thrombosis,and it made more safely in thrombolytic and anticoagulant theropy. It is important in decreasing the mortality and sequelae. Selecting indication strictly of VCF also according to pulmonary artery pressure and cTnI etc.