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超声引导经皮穿刺下腔静脉滤器置入术的初步研究 被引量:13

Initial experience of color Doppler ultrasound-guided interior vena caval filter placement
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摘要 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31例下肢深静脉血栓患者行经皮穿刺IVCFI术.结果31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19.7 mm,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31只,其中经右股静脉置入20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100%.随访结果,栓子俘获率29%,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 evaluate the feasibility and clinical value of color Doppler flow imaging(CDFI) guided inferior vena caval filter insertion(IVCFI). Methods Thirty-one consecutive patients with unilateral lower extremity deep venous thrombosis were selected for IVCFI. Screening CDFI was performed in all the patients. Locations of renal veins (RV),maximum diameter of the inferior vena cava (IVC),and presence or absence of thrombus were documented. If visualization was adequate,IVCFI was performed under guidance of CDFI. CDFI and abdominal plain film of radiograph were used to document proper deployment,and circumferential engagement of the filter struts in the IVC wall. Also,CDFI was repeated each one month to assess IVC filter migration,thrombus adherent to the filter,and IVC patency. Results CDFI visualization was adequate in thirty-one patients(100%) and the average diameter of IVC was 19.7 mm. Thirty-one VenaTech IVC filters were placed without technical difficulty. No technical complication occurred in all the patients. Follow-up examination showed that no filter uncompleted opening and migration and no IVC thrombus were observed. Seven cases (29%) with embolus trapped by IVC filter were found. There had been no report of pulmonary emboli after IVCFI. Conclusions Placement IVC filter is feasible and safe with CDFI. CDFI-guided IVCFI substantially reduces the procedural cost and avoids the need for radiation exposure and intravenous contrast.
作者 李敬府 赵军 王金锐 董国祥 贾建文 白志勇 栾景源 杨玉杰 张武 LI Jing-fu,ZHAO Jun,WANG Jin-rui,et al. Department of Diagnostic Ultrasound,Peking University Third Hospital,Beijing 100083,China
出处 《中华超声影像学杂志》 CSCD 2004年第7期 521-524,共4页 Chinese Journal of Ultrasonography
关键词 超声引导 经皮穿刺 腔静脉滤器置入术 安全性 下肢深静脉血栓 Ultrasonography Vena cava filters Vena cava,inferior Venous thrombusis Leg
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