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[麻醉医生放置临时下腔静脉滤器治疗三踝骨折病例]

[Case of trimalleolar ankle fracture managed by placement of a temporary inferior vena cava filter by an anesthesiologist].

作者信息

Muratani Tadatoshi, Tsunemi Koutaro, Yazu Masaya, Ishizu Tsunehiko

出版信息

Masui. 2014 Jun;63(6):682-5.

Abstract

A patient with trimalleolar ankle fracture was preoperatively diagnosed with deep vein thrombosis (DVT); after induction of general anesthesia, a temporary inferior vena cava filter (TIVCF) was intraoperatively placed by an anesthesiologist. This contributed to safe anesthesia management. A 65-year-old woman was scheduled to undergo surgery for a trimalleolar ankle fracture sustained in an accidental fall. Two days before surgery, leg venous ultrasonography showed DVT. On the day of surgery, after induction of general anesthesia, a TIVCF was inserted by the anesthesiologist. After surgery, the TIVCF was removed, and anesthetic management was completed. On the day after the surgery, anticoagulant treatment was administered. Approximately 3 weeks later, thrombus disappearance was confirmed, and treatment was terminated. DVT is a serious complication that may cause pulmonary thromboembolism. TIVCF is effective in the treatment of DVT, and insertion of the TIVCF used in the present study is relatively simple. TIVCF placement by anesthesiologists, who have reliable knowledge on the various approaches to veins, contributes greatly to securing perioperative patient safety. The collaboration and cooperation of several medical departments are essential for DVT treatment and enhancing perioperative patient safety.

摘要

一名三踝骨折患者术前被诊断为深静脉血栓形成(DVT);全身麻醉诱导后,麻醉医生在术中放置了临时下腔静脉滤器(TIVCF)。这有助于安全的麻醉管理。一名65岁女性因意外摔倒导致三踝骨折,计划接受手术治疗。手术前两天,腿部静脉超声显示存在DVT。手术当天,全身麻醉诱导后,麻醉医生插入了TIVCF。术后,取出TIVCF,完成麻醉管理。术后第二天,给予抗凝治疗。大约3周后,确认血栓消失,治疗终止。DVT是一种可能导致肺血栓栓塞的严重并发症。TIVCF在DVT治疗中有效,本研究中使用的TIVCF插入相对简单。麻醉医生对静脉的各种入路有可靠的知识,由他们放置TIVCF对确保围手术期患者安全有很大帮助。多个医学科室的协作与合作对于DVT治疗和提高围手术期患者安全至关重要。

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