下腔静脉滤器在急性下肢深静脉血栓形成导管接触性溶栓治疗中的临床应用

目的探讨下腔静脉滤器在急性下肢深静脉血栓形成(DVT)导管接触性溶栓(CDT)治疗中的临床应用。方法回顾性分析2009年10月～2010年12月我科收治的72例急性下肢DVT患者的临床资料。均置入下腔静脉滤器,然后以CDT治疗为主的综合治疗。通过电话、血管彩超及血管造影的方法进行随访,观察下肢深静脉通畅率,有无肺动脉栓塞(PE)发生,滤器内血流通畅情况及滤器并发症发生情况。结果随访3～24个月,平均(8±0.4)个月,2例失访。下肢深静脉通畅率为(60.03±13.48)%,治疗期间有2例发生轻度PE症状,保守治疗后症状缓解。血管造影发现滤器内拦截血栓者12例,及时予以滤器内置管溶栓及导管吸栓后,血栓基本清除。随访发现滤器内血流通畅率为93.02%。结论对于急性下肢DVT行CDT治疗的患者,放置下腔静脉滤器是一种安全有效的辅助方法,有效避免了PE的发生,降低溶栓治疗的风险。

The clinical application of inferior vena cava filter in catheter directed thrombolysis therapy

Objective To discuss the clinical application of inferior vena cava filter (IVCF) in catheter directed thrombolysis (CDT) therapy. Methods The study involved 72 patients with acute deep venous thrombosis (DVT) of lower extremity reviewed from Oct.2009 to Dec.2010. All the patients underwent CDT therapy after placement of IVCF. During the follow-up,lower extremity veins patency rate,pulmonary embolism (PE), filter patency rate and filter related complications were observed. Results Two patients developed PE during therapy and symptoms improved after conservative therapy. Seventy patients were followed up for a mean duration of (8±0.4) months (range, 3～24 months) , 2 cases lost. The lower extremity veins patency rate was (60.03±13.48)%. Thrombosis were intercepted by the filters in 12 cases and cleared by catheter-directed thrombolysis and catheter suck. The filters patency rate was (93.02±2.56)%. Conclusion The clinical application of IVCF, which can prevent the occurrence of PE and reduce the risk of thrombolysis, is safe and effective in CDT therapy.