摘要
目的探讨血栓消融的操作方法、下腔静脉滤器的选择及放置时间。方法选择严重急性下肢深静脉血栓 5 5例 ,先置入下腔静脉滤器 ,再用Amplatz血栓消融器进行血栓消融、球囊导管扩张髂静脉病变、股动静脉临时性动静脉造瘘术治疗。结果 5 2例治疗成功 ,造影见髂静脉狭窄 4 7例 ,用球囊导管扩张 ,2 0例置入永久性滤器 ,32例置入临时性滤器。随访 5 0例 ,3～ 30个月 ,4 6例患肢肿胀消退 ,无血栓后综合征表现。结论本方法创伤小、恢复快、多数患者能耐受、效果良好 ,术中需反复造影以观察髂静脉狭窄和残余血栓等情况 ,下腔静脉滤器以临时性为首选。
Objective To explore the appropriate method for mechanical thrombectomy, selection of vena cava filter and its duration in place. Method Fifty-five cases of severe acute deep vein thrombosis of the lower limbs were enrolled. Vena cava filter was first placed, then thrombectomy was performed with Amplatz thrombectomy device (ATD). The iliac vein lesions were dilated by balloon followed by temporary arterivenous fistula construction. Result Procedures were all successful in 52 cases, iliac vein stenosis was found in 47 cases and dilated by balloon. Permanent vena cava filters were placed in 20 cases while temporary in 32 cases. Fifty cases were followed-up for 3～30 monthes. Tumefaction disappeared in 46 cases leaving no after thrombosis syndrome. Conclusion This comprehensive modality is effective, less traumatic and of quick recovery. During the procedure, possible residual thrombi should always be under close attention and stenosis in iliac veins be confirmed by repeated venography. In most cases, placing a temporary vena cava filter was the best choice.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第9期524-526,共3页
Chinese Journal of General Surgery
基金
安徽省科委"十五"科技攻关基金资助项目(0 10 13 0 2 8)
