与腔静脉滤器植入相关的肺栓塞的预防

Prevention of pulmonary embolisms associated with vena cava filter implantation.

作者信息

Han Bing, Ge Chang-Qing, Zhang Hong-Guang, Zhou Chen-Guang, Ji Guo-Hui, Yang Zheng, Zhang Liang

机构信息

Department of Vascular Surgery, The Second Hospital of Baoding City, Baoding 071051, Hebei Province, China

Department of Vascular Surgery, The Second Hospital of Baoding City, Baoding 071051, Hebei Province, China.

出版信息

Phlebology. 2015 Feb;30(1):24-31. doi: 10.1177/0268355514529757. Epub 2014 Mar 26.

DOI:10.1177/0268355514529757

PMID:24671526

Abstract

OBJECTIVE

To investigate the prevention of pulmonary embolism (PE) by the implantation of inferior vena cava filters (IVCFs).

METHODS

Data of 1058 patients treated for lower extremity deep vein thrombosis (DVT) between January 2005 and January 2012 were analyzed retrospectively and divided into those with and without PE.

RESULTS

Of the 1058 patients, 34 had PEs (3.2%) and 1024 did not. Multivariable analyses showed that PEs were less likely to occur in patients with IVCFs than in those without IVCFs (odd ratio [OR] = 0.028, P < 0.001), and were more likely to occur in patients with vena cava thrombosis than in those without vena cava thrombosis (OR = 19.094, P < 0.001). Analyses stratified by DVT site showed that vena cava thrombosis was the only risk factor of PE for patients with a left DVT (crude OR = 12.814, P < 0.001), and IVCF implantation was the only protective factor for PE for patients with a right or bilateral DVT (crude OR = 0.028, P = 0.001). IVCF patency rate for follow-up was 98.7% with no filter migration, declination, or failure of expansion.

CONCLUSIONS

IVCFs can reduce the occurrence of PEs in patients with DVTs.

摘要

目的

探讨植入下腔静脉滤器（IVCF）预防肺栓塞（PE）的效果。

方法

回顾性分析2005年1月至2012年1月期间接受下肢深静脉血栓形成（DVT）治疗的1058例患者的数据，并将其分为发生PE和未发生PE两组。

结果

1058例患者中，34例发生PE（3.2%），1024例未发生。多变量分析显示，植入IVCF的患者发生PE的可能性低于未植入IVCF的患者（比值比[OR]=0.028，P<0.001），而腔静脉血栓形成的患者发生PE的可能性高于无腔静脉血栓形成的患者（OR=19.094，P<0.001）。按DVT部位分层分析显示，腔静脉血栓形成是左下肢DVT患者发生PE的唯一危险因素（粗OR=12.814，P<0.001），而IVCF植入是右下肢或双侧DVT患者预防PE的唯一保护因素（粗OR=0.028，P=0.001）。随访期间IVCF通畅率为98.7%，无滤器移位、倾斜或扩张失败。