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目的评价非永久型下腔静脉滤器预防下肢深静脉血栓(DVT)脱落导致肺栓塞(PE)的安全性和有效性。方法回顾性分析2003年9月~2006年6月在我院收治的12例使用非永久型滤器的DVT患者的临床资料。结果12例患者中,10例采用临时型滤器,2例采用可回收滤器,所有植入手术均获得成功,无严重并发症。10例临时滤器患者中,9例在术后4周成功取出滤器,1例出现滤器周围巨大血栓,继续给予抗凝治疗于术后12周取出。2例可回收滤器中,1例于术后2周成功取出;1例因捕捉巨大血栓,将滤器留置体内。12例患者中,滤器抓捕血栓6例(50%),其中2例(16.6%)血栓>2cm,1例(8.3%)>1cm,3例(25%)<1cm。10例患者在术前进行了PE影像学检查,其中5例有PE;8例患者在术后6个月行PE检查,其中4例有小面积PE,但较治疗前均已有显著改善。12例患者均进行了有效随访,随访时间3个月~2年,其中10例患者随访时间>6个月,1例患者在术后4个月因恶性肿瘤死亡,1例临时滤器在术后出现下腔静脉梗阻,5例PE患者均有缓解。结论非永久型滤器可有效预防PE发生,但在某些技术细节上还需进一步研究和改善。
Objective To evaluate the safety and efficacy of non-permanent IVF filters for prevention of pulmonary embolism (PE) caused by shedding of deep venous thrombosis (DVT) in lower extremities. Methods The clinical data of 12 patients with DVT using non-permanent filter were retrospectively analyzed from September 2003 to June 2006 in our hospital. Results Of the 12 patients, 10 were temporary filters and 2 were disposable filters. All implants were successful without serious complications. Among the 10 patients with temporary filter, 9 patients successfully removed the filter 4 weeks after operation, 1 patient developed massive thrombus around the filter and continued to receive anticoagulant therapy 12 weeks after operation. Of the 2 recoverable filters, 1 had been successfully removed 2 weeks after surgery and 1 patient had been left in the body due to the capture of a massive thrombus. Of the 12 patients, 6 (50%) were caught by the filter, of which 2 (16.6%) had thrombus> 2 cm, 1 (8.3%)> 1 cm and 3 (25%) <1 cm. Ten patients underwent preoperative PE imaging examination, five of which had PE. Eight patients underwent PE examination at 6 months after operation. Four of them had a small area of PE, which was significantly improved compared with that before treatment. All the 12 patients were followed up for 3 months to 2 years, of which 10 patients were followed up for 6 months, 1 patient died of malignant tumor 4 months after operation, 1 patient had temporary filter after operation Inferior vena cava obstruction, 5 cases of PE patients were relieved. Conclusion Non-permanent filter can effectively prevent the occurrence of PE, but some technical details need further study and improvement.