双下腔静脉合并下肢深静脉血栓滤器植入方案初探.pdfVIP

双下腔静脉合并下肢深静脉血栓滤器植入方案初探 田轩 刘建龙 贾伟 蒋鹏 [摘要] 目的 探讨双下腔静脉合并下肢深静脉血栓的特点、诊断治疗及合 理的滤器植入方案。方法 回顾性分析北京积水潭医院血管外科2006年7月～2012 年6月共收治双下腔静脉畸形合并下肢深静脉血栓患者7例，对其滤器植入的适应 证、植入滤器类型以及转归进行分析讨论。结果 本组7例均有明确的滤器植入指 征，其中临时滤器1例，可回收5例，永久滤器1例，临时滤器1例及可回收滤器4 例取出，一例因滤器下血栓过多转换为永久。随访1～72个月，术后口服抗凝药 物，无复发及肺栓塞病例发生。结论 双下腔静脉合并下肢深静脉血栓发生率低， 无临床特异性易于忽视。滤器植入的位置不合适可能是滤器植入后致死性肺栓塞 的原因之一，反之于合理位置可获得满意的拦截效果。 [关键词] 双下腔静脉；下肢深静脉血栓；肺栓塞 Investigation of Double Inferior Vena Cava Filter Insertion in Subjects with Deep Venous Thromboembolism TIAN Xuan, LIU Jianglong, JIA Wei, JIANG Peng Department of Vascular Surgery, Beijing JiShuiTan Hospital, Beijing 100035，China [Abstract] Objective To investigate the characteristic, diagnosis, and treatment of deep venous thromboembolic subjects with congenital double inferior vena cava. Methods This is a retrospective analysis focus on the indication, filter type and efficacy of vena cava filter insertion in seven deep venous thromboembolic subjects with congenital double inferior vena hospitalized in our hospital from year 2006 to 2012. Results All seven subjects presented with vena cava filter insertion indication. Temporary vena caval filter and permanent vena caval filter was implanted in one subject respectively. Retrievable vena caval filters were implanted in the other five subjects.One retrievable filter was replaced by a permanent filter due to excessive thrombus entrapped in the filter. Other temporary or retrievable filters were extracted successfully. All subjects were prescribed with oral anitcoagulants after surgery. The follow up time is from one to seventy two months. No recurrent DVT or pulmonary embolism was identified. Conclusion The complication of double inferior vena cava in DVT subjects were often misdiagnosed due to its low incidence rate and lack of clinical manifestations. Fatal pulmonary embolism after implantation might due to the inappr