下腔静脉滤器植入在无抗凝治疗下预防复发性肺栓塞的临床疗效分析

发布时间：2018-11-08 13:52

【摘要】：目的探讨下腔静脉滤器(IVCF)植入在无抗凝治疗下预防复发性肺栓塞的临床疗效。方法回顾性分析2014年11月至2016年11月期间在我院住院治疗的265例肺栓塞患者的临床资料,按照治疗方式分为IVCF治疗组(55例)和抗凝治疗组(210例)。两组患者出院后定期门诊复查随访3个月至2年。比较两组患者一般资料、1年内肺栓塞及深静脉血栓形成(DVT)复发率,以及1年内、2年内死亡率。结果 IVCF组肺栓塞复发率为9.1%,DVT复发率为21.8%,抗凝治疗组肺栓塞复发率为18.6%,DVT复发率为11.0%。IVCF组肺栓塞复发率低于抗凝治疗组,DVT复发率高于抗凝治疗组,差异有统计学意义(P0.05)。两组患者1年期(29.1%vs.12.9%)及2年期(34.5%vs.14.8%)死亡率比较,差异有统计学意义(P0.05)。结论在无抗凝治疗下植入IVCF可降低下肢深静脉血栓致肺栓塞的发生率,但会提高DVT复发率,适用于肺栓塞抗凝治疗禁忌证或规范抗凝治疗后肺栓塞复发患者。
[Abstract]:Objective to investigate the clinical effect of (IVCF) implantation of inferior vena cava filter in the prevention of recurrent pulmonary embolism without anticoagulant therapy. Methods the clinical data of 265 patients with pulmonary embolism who were hospitalized in our hospital from November 2014 to November 2016 were analyzed retrospectively. According to the treatment mode, the patients were divided into two groups: IVCF group (55 cases) and anticoagulant group (210 cases). The patients in both groups were followed up for 3 months to 2 years after discharge. The general data of the two groups, the recurrence rate of pulmonary embolism (PE) and deep venous thrombosis (DVT) within 1 year, and the death rate within 1 year and 2 years were compared between the two groups. Results the recurrence rate of pulmonary embolism in IVCF group was 9.1%. The recurrence rate of pulmonary embolism in anticoagulant treatment group was 18.6%. The recurrence rate of pulmonary embolism in 11.0%.IVCF group was lower than that in anticoagulant treatment group. The recurrence rate of DVT was higher than that of anticoagulant treatment group (P0.05). There were significant differences in mortality between the two groups (29.1vs.12.9%) and 2-year (34.5vs.14.8%) (P0.05). Conclusion implantation of IVCF without anticoagulant therapy can reduce the incidence of pulmonary embolism caused by deep vein thrombosis of lower extremity, but it can increase the recurrence rate of DVT. It is suitable for patients with recurrent pulmonary embolism after contraindication of anticoagulant therapy or standard anticoagulant therapy.
【作者单位】：宝鸡市中心医院呼吸内科;宝鸡市中心医院感染性疾病科;
【分类号】：R563.5

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