摘要
目的总结TempofilterⅡ型下腔静脉临时滤器应用的临床经验。方法对2002年4月~2006年8月间的24例需要置入下腔静脉临时滤器的患者,应用彩超了解血栓范围,下腔静脉、肾静脉和入路静脉(右颈内静脉)的情况,在彩超和X线透视下(免造影剂),应用Seldinger穿刺技术,通过导丝导管将临时滤器放在肾静脉开口远端的下腔静脉内。结果24例均成功置入和拔除。置入时间5 d^6周,平均16.8 d。其中滤器处下腔静脉血栓形成4例,发生在3 d^2周。捕获血栓8例,血栓均<0.5 cm。随访23例,平均23个月(7~57个月),无再次发生肺栓塞病例,1例下肢深静脉血栓复发,经抗凝治疗后好转。结论TempofilterⅡ型下腔静脉临时滤器是安全和有效的;超声结合X线透视免去造影剂的置入操作是安全和可行的;多数可以在3周时拔除,如果滤器血栓形成应及时处理。
Objective To summarize the clinical application of the Tempofiher Ⅱ temporary caval filter. Methods The Tempofiher Ⅱ temporary caval filter was employed in 24 patients from April 2002 to August 2006. Before the implantation, we performed color ultrasonography to detect the extent of thrombus and the situation of inferior vena cava, renal vein, and access vein （right internal jugular vein）. Under the guidance of color ultrasonography and X-ray fluoroscopy （free of contrast agent）, the temporary filter was placed in the inferior vena cava distal of the renal vein orifice through a guide wire by using the Seldinger technique. Results The filter was successfully implanted and removed in all the 24 patients. The duration of placement was 5 days -6 weeks （mean, 16.8 days）. Filter thrombosis occurred in 4 patients at 3 days - 2 weeks after operation. The thrombi （ 〈 0. 5 cm in diameter） were trapped by the filter in 8 patients. Twenty-three patients were followed for a mean of 23 months. No recurrence of pulmonary embolism was seen. Deep venous thrombosis in lower limbs recurred in 1 patient and was relieved by anticoagulation therapy. Conclusions The application of the Tempofilter Ⅱ filter is safe and effective. It can be safely implanted under color ultrasonography and X-ray fluoroscopy. In most patients the filter can be removed in 3 weeks. Filter thrombosis should be timely treated.
出处
《中国微创外科杂志》
CSCD
2007年第7期607-608,共2页
Chinese Journal of Minimally Invasive Surgery
