血管内超声引导下为军事多发伤患者置入下腔静脉滤器：单中心经验

Intravascular ultrasound--guided inferior vena cava filter placement in the military multitrauma patients: a single-center experience.

作者信息

Aidinian Gilbert, Fox Charles J, White Paul W, Cox Mitchell W, Adams Eric D, Gillespie David L

机构信息

Department of Surgery, Peripheral Vascular Surgery Service, Walter Reed Army Medical Center, Washington, D.C., USA.

出版信息

Vasc Endovascular Surg. 2009 Oct-Nov;43(5):497-501. doi: 10.1177/1538574409334824. Epub 2009 Jul 29.

DOI:10.1177/1538574409334824

PMID:19640915

Abstract

BACKGROUND

High velocity fragments have resulted in a multitude of complex injuries in the military patients, placing them at increased risk of venous thromboembolism.

METHODS

A retrospective analysis was performed of all the intravascular ultrasound (IVUS)-guided bedside inferior vena cava (IVC) filters placed between August 2003 and October 2007.

RESULTS

Fourteen patients had bedside IVUS-guided retrievable filter placement. Thirteen males and one female and the mean (+SD) injury severity scores (ISS) was 37.2 (+9.9). The most common causes of injury were explosive devices (57%), gunshot wounds (28%), rocket-propelled grenades (7%), and motor vehicle crashes (7%). Indications for filter insertion were deep venous thrombosis in 36% of patients and pulmonary embolus in 28%. Thirty five percent had filters inserted prophylactically.

CONCLUSIONS

Military trauma population ISS is considerably higher than what is reported in the civilian population. The bedside IVUS-guided IVC filter insertion is particularly useful in this population.

摘要

背景

高速碎片导致大量军事伤员出现复杂损伤，使其静脉血栓栓塞风险增加。

方法

对2003年8月至2007年10月期间所有在血管内超声（IVUS）引导下于床旁置入下腔静脉（IVC）滤器的病例进行回顾性分析。

结果

14例患者接受了床旁IVUS引导下可回收滤器置入术。其中13例男性，1例女性，平均（+标准差）损伤严重程度评分（ISS）为37.2（+9.9）。最常见的致伤原因是爆炸装置（57%）、枪伤（28%）、火箭推进榴弹（7%）和机动车碰撞（7%）。滤器置入的指征为36%的患者存在深静脉血栓形成，28%的患者存在肺栓塞。35%的患者为预防性置入滤器。