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目的探讨经皮穿刺下腔静脉滤器置入术在治疗下肢深静脉血栓中预防肺动脉栓塞的作用。方法2003年3月至2005年2月,经股静脉或颈静脉穿刺放置永久性下腔静脉滤器61例,男性34例,女性27例,年龄34～90岁,平均66.7岁。深静脉血栓位于右下肢24例,左下肢34例,双下肢3例。常规行下腔静脉造影,了解并确定下腔静脉和释放途径无血栓形成,将滤器放置到肾静脉开口下的腔静脉。结果本组病例均释放成功,其中3例双下肢深静脉血栓的患者经颈静脉释放,其余均经股静脉释放;2例在超声定位下释放,其余均在静脉造影下完成。术后随访1～18个月,均无肺栓塞发生。结论经皮穿刺下腔静脉滤器置入术操作简便,可以有效预防下肢深静脉患者肺动脉栓塞的发生。
Objective To investigate the effect of percutaneous puncture in inferior vena cava filter on the prevention of pulmonary embolism in deep venous thrombosis of lower limbs. Methods From March 2003 to February 2005, 61 cases of permanent inferior vena cava filters were punctured by femoral vein or jugular vein puncture. There were 34 males and 27 females, aged 34-90 years (average 66.7 years). Deep vein thrombosis in the right lower limb in 24 cases, 34 cases of left lower limbs, 3 cases of both lower extremities. Conventional vena cava angiography, to understand and determine the vena caval and release-free thrombosis, the filter placed below the opening of the renal vein vena cava. Results All the patients were successfully released. Three patients with deep venous thrombosis of both lower extremities were released through the jugular vein and the rest were released through the femoral vein. Two patients were released under ultrasound and the rest were performed under intravenous angiography. Follow-up 1 to 18 months after surgery, no pulmonary embolism occurred. Conclusions Percutaneous puncture of IVC filter is simple and convenient, which can effectively prevent pulmonary embolism in patients with deep venous lower extremity.