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目的 探讨超声引导经皮穿刺下腔静脉滤器置入 (IVCFI)术的可行性、安全性和临床实用价值。方法 在彩色多普勒血流显像 (CDFI)引导下 ,对连续收治的 3 1例下肢深静脉血栓患者行经皮穿刺IVCFI术。结果 3 1例患者术前CDFI检查下腔静脉、肾静脉及其最低入口显示清晰 ,下腔静脉平均内径19 .7mm ,无变异和血栓 ,符合所选滤器置入要求。在CDFI引导下 ,置入VenaTech永久型滤器 3 1只 ,其中经右股静脉置入 2 0只 ,左股静脉置入 11只。术后CDFI和X线腹部平片均证实滤器置入位置正确 ,张开完全 ,无并发症 ,技术成功率为 10 0 %。随访结果 ,栓子俘获率 2 9% ,滤器无变形和移位 ,局部无血栓形成 ,也无滤器置入后肺血栓栓塞临床病例发生。结论 超声引导是经皮穿刺IVCFI术安全、可靠的方法 ,同时也是简便易行、无污染、费用低廉的实用方法。
Objective To investigate the feasibility, safety and clinical value of ultrasound guided percutaneous veno-perfusion inferior vena cava filter implantation (IVCFI). Methods Under the guidance of color Doppler flow imaging (CDFI), we performed percutaneous puncture IVCFI on 31 consecutive patients with deep venous thrombosis of lower extremity. Results 3 cases of patients with preoperative CDFI examination of the inferior vena cava, renal vein and its lowest entrance showed clear, the average diameter of the inferior vena cava 19.7mm, no variation and thrombosis, in line with the selected filter placement requirements. Under the guidance of CDFI, 31 VenaTech permanent filters were placed, of which 20 were injected into the right femoral vein and 11 into the left femoral vein. Postoperative CDFI and X-ray plain film were confirmed correct placement of the filter, open completely, no complications, the technical success rate was 10%. Follow-up results, embolism capture rate of 29%, no deformation and displacement of the filter, no local thrombosis, no filter after the establishment of clinical cases of pulmonary thromboembolism. Conclusion Ultrasound guided percutaneous puncture IVCFI safe and reliable method, but also simple, pollution-free, low-cost practical method.