Oshima Kiyohiro, Kunimoto Fumio, Hinohara Hiroshi, Ohkawa Makio, Saito Shigeru
Gunma University Hospital, Gunma, Japan.
Int Heart J. 2008 Nov;49(6):713-21. doi: 10.1536/ihj.49.713.
We studied the clinical courses of patients with deep vein thrombus (DVT) who underwent insertion of temporary inferior vena cava filters (tIVCF) and evaluated the effectiveness of the tIVCF. From January 2003 to March 2008, tIVCF were placed in 12 patients with a diagnosis of DVT in the Intensive Care Unit (ICU) of Gunma University Hospital. The mean age of the patients was 52 +/- 16 years (range, 18-82). Eight were medical patients who had not undergone any prior surgery, and 4 were postoperative patients, including 3 with a malignancy. The diagnosis of DVT was made using enhanced computed tomography. The Toray Neuhaus Protect catheter (6Fr, Toray Medical, Tokyo) was used as a tIVCF in all 12 patients. We evaluated the clinical course of the patients before and after placement of a tIVCF and studied their prognosis. DVT occurred on 15 +/- 9 days after surgery or admission to hospital. Pulmonary thromboembolism (PTE) was detected in 7 patients prior to the placement of a tIVCF, 3 of whom required cardiopulmonary resuscitation. The mean duration of tIVCF placement was 18 +/- 9 days; no episodes of PTE occurred after tIVCF placement. DVT completely or almost completely disappeared during the period of tIVCF placement; subsequently, tIVCFs were successfully removed in 10 patients (83%). A permanent IVCF was placed in only 1 patient, and the tIVCF was removed in the remaining patient because of suspected catheter infection. There were 2 complications related to tIVCF placement: infection at the insertion site and suspected catheter infection. tIVCF placement could prevent the occurrence of PTE without provoking life-threatening complications. The results suggest that tIVCF is useful in the prevention of PTE in patients with DVT.
我们研究了接受临时下腔静脉滤器（tIVCF）植入的深静脉血栓（DVT）患者的临床病程，并评估了tIVCF的有效性。2003年1月至2008年3月，群马大学医院重症监护病房（ICU）对12例诊断为DVT的患者植入了tIVCF。患者的平均年龄为52±16岁（范围18 - 82岁）。8例为未接受过任何先前手术的内科患者，4例为术后患者，其中3例患有恶性肿瘤。DVT的诊断采用增强计算机断层扫描。所有12例患者均使用东丽Neuhaus Protect导管（6Fr，东丽医疗，东京）作为tIVCF。我们评估了患者在植入tIVCF前后的临床病程，并研究了他们的预后。DVT在手术后或入院后15±9天发生。在植入tIVCF之前，7例患者检测到肺血栓栓塞（PTE），其中3例需要心肺复苏。tIVCF的平均植入时间为18±9天；植入tIVCF后未发生PTE事件。在tIVCF植入期间，DVT完全或几乎完全消失；随后，10例患者（83%）成功取出了tIVCF。仅1例患者植入了永久性IVCF，其余1例患者因怀疑导管感染而取出了tIVCF。有2例与tIVCF植入相关的并发症：插入部位感染和疑似导管感染。tIVCF植入可预防PTE的发生，且不会引发危及生命的并发症。结果表明，tIVCF对预防DVT患者的PTE有用。
