摘要
目的总结因下肢深静脉血栓形成(DVT)导致肺栓塞(PE)发生的概率,探讨应用腔静脉滤器(VCF)植入预防PE发生的情况。方法回顾性分析我院2005年1月至2012年1月期间收治的1 058例下肢DVT患者的临床资料。结果 1 058例DVT患者中发生PE者34例(3.21%),发生死亡者15例(1.42%)。其中887例未植入VCF者中发生PE者32例(3.61%),死亡15例(1.69%);171例植入VCF者中发生PE者2例(1.17%),无死亡患者。植入VCF的171例患者中经股静脉植入151例,经颈静脉植入20例;VCF植入后3～4周内回收,尝试回收145例,成功回收139例,其中经颈静脉回收13例,126例经股静脉回收。PE和死亡的发生时间均集中在10 d内,PE发生最长时间为35 d。未植入VCF患者的PE发生率及死亡率均明显高于植入VCF患者(P<0.01)。未植入VCF患者的PE发生率及死亡率双下肢均明显高于右下肢及左下肢(P<0.05),右下肢明显高于左下肢(P<0.05)。下肢DVT合并下腔静脉血栓者PE发生率及死亡率均明显高于中心型(P<0.05),中心型明显高于周围型(P<0.05),周围型与混合型间差异无统计学意义(P>0.05)。随访(39±19)个月(1个月～7年),VCF的累积通畅率为98.7%。植入的滤器无移位、倾斜和扩张不良。结论 VCF植入能有效预防PE,但应严格掌握适应证。
Objective To summarize the probability of pulmonary embolism（PE）induced by lower extremity deep venous thrombosis（DVT）and investigate the role of vena cava filter（VCF）in preventing from PE.Methods The clinical data of 1 058 patients with lower extremity DVT from January 2005 to January 2012 were analyzed retrospectively.Results The PE rate was 3.21%（34/1 058）and the death rate was 1.42%（15/1 058）in 1 058 patients with lower extremity DVT.The VCF was implanted in 171 of 1 058 patients.The VCFs of 151 patients were implanted from femoral vein,20 patients were implanted from jugular vein.The PE rates were 3.61%（32/887）and 1.17%（2/171）and the death rates were 1.69%（15/887）and 0（0/171）in patients without VCF and with VCF,respectively.Both of them occurred in the first ten days.PE could keep as long as 35 d.The PE rate and death rate in the patients without VCF were significantly higher than those in the patients with VCF（P0.01）.The PE rates and death rates in both lower extremities DVT were higher than those in patients with the right and left ones（P0.05）,which in the right lower extremity were higher than those in the left one（P0.05）.The PE rate and death rate in the patients with lower extremity DVT combined with vena cava thrombosis were significantly higher than those in the patients with central type（P0.05）,which in the central type were significantly higher than those in the peripheral type（P0.05）,there were no significant differences between peripheral type and mixed pattern.The follow-up time was from 1 month to 7 years with（39±19） months,the patency rate of VCF was 98.7%.There were no filter migration,declination,and failure of expansion.Conclusions VCF can prevent from PE effectively,but the indications must be controlled.
出处
《中国普外基础与临床杂志》
CAS
2012年第11期1156-1162,共7页
Chinese Journal of Bases and Clinics In General Surgery
关键词
深静脉血栓形成
肺栓塞
腔静脉滤器
适应证
通畅率
Deep venous thrombosis
Pulmonary embolism
Vena cava filter
Indication
Patency rate
