下腔静脉滤器置入术62例报告

目的：探讨下腔静脉滤器置入在急性下肢深静脉血栓溶栓治疗中预防肺栓塞的应用价值。方法：61例下肢深静脉血栓患放置了62枚滤器。结果：本组60例患滤器成功置入，1例VENA TECH滤器释放后未打开，另于原位释放滤器一枚。两例长鞘穿破健侧骼静脉，术中及时发现，术后造影及随访未发现异常。本组病例随访1～30个月，发现滤器堵塞两例，经紧急溶栓后再通。滤器侧倾6例，角度均小于15度。未发现滤器移位，无穿刺部位血肿及健侧血栓形成。结论：在急性下肢深静脉血栓抗凝溶栓治疗前置入下腔静脉滤器，是预防肺栓塞安全有效的方法。

62 Inferior Vena Cava Filters Insertion in Acute Lower Extreimty Deep Venous Thrombosis with Thrombolytic Therapy

Objective: To evaluate the value of the venacava filter in the prevention of pulmonary embolism in acute lower extreim-ty deep venous thrombosis (DVT) cases with thrombolytic therapy. Methods: 62 filters were implanted in inferior vena cava below the renal vein in 61 patients. Results: The implanted success rate is 100% . But one VENA TECH filter wasn't open during implantation, so the second same filter was placed in inferior vena cava. During operation, 2 cases' common iliac vein was penetrated, then no complications were found during operation and follow- up. During 1 ~ 30 months' follow up, two filters were occluded by acute thrombosis, but vena cava were re - opened by anti - thrombosis; 6 filters were angled, the angle was less than 15 degree (from the vertical), no filter migration, haematoma in skin puncture place and thrombosis in normal iliac vein weren't observed. Conclusion: To prevent pulmonary embolism, it is effective to inferior vena cava filter insertion before the patient with acute DVT is given by thrombolytic therapy.