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目的探讨经肘下腔静脉滤器置入的方法及并发症的防治。方法2004年10月至2006年5月我科收治的下肢深静脉血栓形成(DVT)患者中,有6例采取经肘静脉穿刺下腔静脉滤器置入。6例均经右肘正中静脉或贵要静脉穿刺,将SNF(Simon nitinol filter,Bard)沿90cm长鞘置入下腔静脉。结果6例手术均1次成功,用时平均25min。除1例肘部穿刺点有轻度红肿外,其余均愈合良好,无出血或血肿,无静脉炎。滤器位置准确,无偏斜。患者均无肺栓塞发生。结论经肘下腔静脉滤器置入术穿刺容易,创伤小,术后患者无需卧床制动,有利于DVT的治疗。同时,对于经股静脉穿刺有禁忌的DVT患者,经肘下腔静脉滤器置入更不失为较好的替换选择。
Objective To investigate the method of inserting the elbow inferior vena cava filter and the prevention and treatment of complications. Methods From October 2004 to May 2006, 6 cases of lower extremity deep venous thrombosis (DVT) admitted to our department were treated with inferior vena cava needle puncture in inferior vena cava filter. All 6 patients underwent insertion into the inferior vena cava with a 90 cm long sheath by inserting the SNF (Simon nitinol filter, Bard) through the right elbow median vein or venous catheter. Results 6 cases of surgery were successful in 1 case, with an average of 25min. In addition to a case of elbow puncture point mild swelling, the rest were healed well, no bleeding or hematoma, no phlebitis. The filter is in an exact position without skew. None of the patients had pulmonary embolism. Conclusion The inferior vena cava vena cava filter insertion puncture easy, less trauma, postoperative patients without bed brake, is conducive to the treatment of DVT. At the same time, for patients with contraindications to femoral vein puncture DVT, the elbow vena cava filter placement is a better alternative.