可回收腔静脉滤器在下肢骨折伴深静脉血栓患者中的应用
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摘要
目的探讨下肢或盆骨骨折合并下肢深静脉血栓(DVT)患者置入可回收下腔静脉滤器预防围术期肺栓塞的价值。方法回顾性分析168例下肢或盆骨骨折合并DVT置入腔静脉滤器患者的临床资料,统计滤器回收率及血栓拦截率的情况。结果本组168例患者均成功置入滤器,并于(48.3±4.8) d(14～97 d)后取出可回收滤器;其中159例成功取出滤器,取出率为94.6%,经造影检查或取出腔静脉滤器时发现滤器上有血栓者61例,即血栓拦截率为36.3%(61/168)。结论下肢或盆骨骨折合并DVT患者置入可回收腔静脉滤器可有效拦截血栓、避免肺栓塞的发生。
Objective To explore the value of recombinant inferior vena cava filter(IVCF) in the prevention of perioperative pulmonary embolism in patients with lower limb or pelvic fracture combined with deep venous thrombosis(DVT). Methods The clinical data of 168 patients with lower limb or pelvic fracture combined with DVT were analyzed retrospectively. Results The filters were successfully implanted in 168 patients, and the recoverable filters were removed after(48.3±4.8) d(14–97 d). The filters were removed successfully in 159 cases, and the removal rate was94.6%. Sixty-one cases were found to have thrombus on the filter after contrast examination or removal of vena cava filter, that is, the thrombus interception rate was 36.3%. Conclusion For patients with lower limb or pelvic fracture combined with DVT, the rechargeable vena cava filter can effectively stop thrombosis and avoid pulmonary embolism.
Objective To explore the value of recombinant inferior vena cava filter(IVCF) in the prevention of perioperative pulmonary embolism in patients with lower limb or pelvic fracture combined with deep venous thrombosis(DVT). Methods The clinical data of 168 patients with lower limb or pelvic fracture combined with DVT were analyzed retrospectively. Results The filters were successfully implanted in 168 patients, and the recoverable filters were removed after(48.3±4.8) d(14–97 d). The filters were removed successfully in 159 cases, and the removal rate was94.6%. Sixty-one cases were found to have thrombus on the filter after contrast examination or removal of vena cava filter, that is, the thrombus interception rate was 36.3%. Conclusion For patients with lower limb or pelvic fracture combined with DVT, the rechargeable vena cava filter can effectively stop thrombosis and avoid pulmonary embolism.
引文
1中华医学会放射学分会介人学组.下腔静脉滤器置人术和取出术规范的专家共识.介入放射学杂志,2011,20(5):340-344.
2潘烨,赵珺,孙玉强,等.下肢骨创伤并深静脉血栓行下腔静脉滤器植人的单中心回顾,性研究.中华外科杂志,2014, 52(4):254-257.
3 Gillern SM, Sheppard FR, Evans KN, et al. Incidence of pulmonary embolus in combat casualties with extremity amputations and fractures. J Trauma, 2011, 71(3):607-613.
4牛鹿原,张欢,张福先.急性下肢深静脉血栓发生症状性肺栓塞的预测.中华普通外科杂志,2017, 32(5):415-417.
5解银立,张大春,支兴兴,等.可回收下腔静脉滤器在骨折合并深静脉血栓中的应用.中国介人影像与治疗,2018, 15(2):69-72.
6中华医学会骨科学分会创伤骨科学组.创伤骨科患者深静脉血栓形成筛查与治疗的专家共识.中华创伤骨科杂志,2013,15(12):1013-1017.
7崔淑君,赵清华,刘青,等.腔静脉滤器产品综述.中国医疗器械杂志,2016, 40(3):191-196.
8袁涛,王志波,毕伟,等.腔静脉滤器的选择性应用.血管与腔内血管外科杂志,2017, 3(1):563-565.
9李军,代远斌.下腔静脉滤器置人预防肺栓塞.中国组织工程研究,2012, 16(16):3001-3004.
10陈晓明.下腔静脉滤器植入术的适应症及其随访管理.循证医学,2016,16(6):335-335.
11 Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease:CHEST guideline and expert panel report. Chest,2016,149(2):315-352.
12张光军,虞贞凤,周文华,等.98例老年急性下肢深静脉血栓形成的诊治分析.中国普外基础与临床杂志,2017, 24(6):732-735.
13周瀚,梁鲁,姚碧辉,等.下肢深静脉血栓稳定性的研究现状及展望.中国普外基础与临床杂志,2017, 24(4):525-528.
14 Postema M, Gilja OH. Contrast-enhanced and targeted ultrasound.World J Gastroenterol, 2011,17(1):28-41.
15徐英江,陈刚,韩新强,等.下腔静脉滤器置人术后血栓形成的诊治分析.临床外科杂志,2018, 26(2):135-137.
2潘烨,赵珺,孙玉强,等.下肢骨创伤并深静脉血栓行下腔静脉滤器植人的单中心回顾,性研究.中华外科杂志,2014, 52(4):254-257.
3 Gillern SM, Sheppard FR, Evans KN, et al. Incidence of pulmonary embolus in combat casualties with extremity amputations and fractures. J Trauma, 2011, 71(3):607-613.
4牛鹿原,张欢,张福先.急性下肢深静脉血栓发生症状性肺栓塞的预测.中华普通外科杂志,2017, 32(5):415-417.
5解银立,张大春,支兴兴,等.可回收下腔静脉滤器在骨折合并深静脉血栓中的应用.中国介人影像与治疗,2018, 15(2):69-72.
6中华医学会骨科学分会创伤骨科学组.创伤骨科患者深静脉血栓形成筛查与治疗的专家共识.中华创伤骨科杂志,2013,15(12):1013-1017.
7崔淑君,赵清华,刘青,等.腔静脉滤器产品综述.中国医疗器械杂志,2016, 40(3):191-196.
8袁涛,王志波,毕伟,等.腔静脉滤器的选择性应用.血管与腔内血管外科杂志,2017, 3(1):563-565.
9李军,代远斌.下腔静脉滤器置人预防肺栓塞.中国组织工程研究,2012, 16(16):3001-3004.
10陈晓明.下腔静脉滤器植入术的适应症及其随访管理.循证医学,2016,16(6):335-335.
11 Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease:CHEST guideline and expert panel report. Chest,2016,149(2):315-352.
12张光军,虞贞凤,周文华,等.98例老年急性下肢深静脉血栓形成的诊治分析.中国普外基础与临床杂志,2017, 24(6):732-735.
13周瀚,梁鲁,姚碧辉,等.下肢深静脉血栓稳定性的研究现状及展望.中国普外基础与临床杂志,2017, 24(4):525-528.
14 Postema M, Gilja OH. Contrast-enhanced and targeted ultrasound.World J Gastroenterol, 2011,17(1):28-41.
15徐英江,陈刚,韩新强,等.下腔静脉滤器置人术后血栓形成的诊治分析.临床外科杂志,2018, 26(2):135-137.