Takahashi Tetsuya, Fukuda Isao, Uchihashi Yoshitaka, Satoh Tetsuo
Division of Anesthesia, SDF-Yokosuka Hospital, Yokosuka 359-8543.
Masui. 2004 Mar;53(3):280-3.
There are several reports on use of a temporary IVC filter (T-IVC-F) in patients with deep vein thrombosis. They conclude that the preoperative insertion of a T-IVC-F is useful to prevent intraoperative pulmonary thromboembolism (PTE). But there is no report on preoperative insertion of T-IVC-F not preventing PTE in perioperative period. We experienced a patient who had developed PTE perioperatively despite preoperative insertion of a T-IVC-F. There is a report that some thrombi are not trapped by T-IVC-F in vitro. This suggests that intraoperative PTE can occur. Then, even if T-IVC-F has been inserted preoperatively, it may cause minor thromboembolism, but not major. Therefore we have to observe the vital signs carefully on monitors, such as, pulmonary arterial pressure, end tidal CO2, and transesophageal echocardiograph.
关于在深静脉血栓形成患者中使用临时下腔静脉滤器(T-IVC-F)已有多篇报道。他们得出结论,术前插入T-IVC-F有助于预防术中肺血栓栓塞(PTE)。但尚无关于术前插入T-IVC-F未能在围手术期预防PTE的报道。我们遇到了一名患者,尽管术前插入了T-IVC-F,但仍在围手术期发生了PTE。有报道称,在体外一些血栓未被T-IVC-F捕获。这表明术中可能发生PTE。那么,即使术前已插入T-IVC-F,它可能导致轻微血栓栓塞,但不会导致严重血栓栓塞。因此,我们必须在监测仪上仔细观察生命体征,如肺动脉压、呼气末二氧化碳分压和经食管超声心动图。