Chinese Journal of Practical Surgery ›› 2021, Vol. 41 ›› Issue (12): 1430-1433.DOI: 10.19538/j.cjps.issn1005-2208.2021.12.24

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  • Online:2021-12-01 Published:2021-12-06

提高下腔静脉滤器回收率核心要点

刘建龙,李金勇   

  1. 北京积水潭医院血管外科,北京100035

Abstract: How to improve the retrieval rate of inferior vena cava filter        LIU Jian-long, LI Jin-yong. Department of Vascular Surgery, Beijing Jishuitan Hospital, Beijing 100035, China 
Corresponding author:LIU Jian-Long,E-mail:ljl_hy88@sina.com
Abstract    Venous thromboembolism(VTE)is one of the most common fatal cardiovascular diseases in hospital.The application of inferior vena cava filter(IVCF)can greatly reduce the occurrence of fatal pulmonary embolism,however, long-term indwelling also brings related complications.An increasing number of guidelines recommend implanting physicians consider removing the filter as soon as protection from PE is no longer needed.However,the total retrievable rate of IVCF is not high due to the unbalanced development of clinical concept and technology.Most filters are eventually permanently placed,so how to reduce the complications of filters and greatly improve the removal rate of IVC filters?The author thinks that the following points should be done.1)clear indications of implantation,strict selection of standardized operation and precise implantation, 2)systematic monitoring of the filter during implantation,timely treatment of primary thrombosis and adequate anticoagulation, 3)effective treatment of IVCF thrombosis, standardized retrievable technology and effective use of various interventional technologies.

Key words: deep venous thrombosis, pulmonary embolism, inferior vena cava filter

摘要: 静脉血栓栓塞症是院内常见的致死性心血管疾病之一,应用下腔静脉滤器能大幅度降低致死性肺栓塞的发生率,同时下腔静脉滤器长期植入带来的相关并发症不可忽视。越来越多的指南推荐当肺栓塞风险可控时应及时回收腔静脉滤器。但是由于临床理念与技术发展差异,临床上下腔静脉滤器的总体回收率并不高,大多数滤器最终还是永久性植入。减少滤器的并发症并大幅度提高下腔静脉滤器回收率须做到以下3点:(1)明确植入指征,严格选择,规范操作,精准植入。(2)植入后对滤器进行系统监测,及时处理原发血栓,充分抗凝。(3)有效处理滤器内血栓,回收技术规范化,充分利用多种介入技术提高回收率。

关键词: 深静脉血栓, 肺栓塞, 下腔静脉滤器