| 摘要: |
| 目的 探讨彩超引导下床旁下腔静脉滤网置入术在住院患者下肢深静脉血栓后肺栓塞预防中的临床应用。方法 2016年10月～2018年10月，我院血管外科对28例确诊为下肢深静脉血栓的患者行彩超引导下下腔静脉滤网置入术，所有手术均在ICU或病房床旁进行。结果 28例手术均顺利完成，成功率达100%，手术时间约 20～35分钟 ，平均时间30分钟，手术全程由彩超实时引导，术前精准定位，术中清晰显示穿刺、置入导管和释放滤器全过程，术后观察滤网位置和通畅性，无1例并发症发生，术后两周23例患者顺利在DSA下取出滤网，术中造影显示滤网位置无移位，其余5例患者术后随访3个月，滤网位置均无移动，其中1例滤网内发现少许血栓，28例患者均未见肺栓塞形成。结论 彩超引导下下腔静脉滤网置入术适用于ICU或者病房床旁不适合搬动的患者，尤其对于重症患者安全、手术时间短、定位引导准确、减少医务人员和患者的放射损伤，适用于对于放射造影剂过敏或肝、肾功能不全的患者，同时减少穿刺并发症，能有效地预防肺栓塞形成，能为临床治疗提供一种新途径。 |
| 关键词: 彩超引导 下腔静脉滤网 床旁 |
| DOI： |
| 投稿时间：2019-05-16修订日期：2020-04-03 |
| 基金项目: |
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| Clinical application of Color Doppler ultrasound guided inferior vena filter implantation bedside in the ward |
| wangjing,wangdong |
| (the first affiliate hospital of chongqing medical university of science) |
| Abstract: |
| Objective To explore the clinical application of bedside color Doppler ultrasound guided inferior vena cava filter implantation in the ward patient for the prevention of pulmonary embolism after deep vein thrombosis. Methods Twenty-eight patients in the ICU or ward who had the deep vein thrombosis of the lower extremities were operated bedside by the vascular surgeon from October 2016 to October 2018. Results All the cases were successful. The operation time was 20～35 min and the average time was 30 min. The whole periods were guided by the ultrasound on real time, Before the operation, the ultrasound doctor assessed the inferior vena cava patency by the color Doppler ultrasound. During the procedure, the doctor had taken the accurate puncture path and guidance of the whole implantation operation. After the operation, the ultrasound doctor made the examination for the filter which location and patency. No complications of vascular related were found after surgery. Conclusion Bedside color Doppler ultrasound guided inferior vena cava filter implantation was simple ,safe, convenient and fast, this way especially for the patient in the ICU or ward who could not be moved. It would avoided the radiation of the X-ray through the conventional operation way to the doctor and patient. This method could not only made operate accurately and reduced the vascular complication effectively, but also was helpful to the clinical treatment and prevent the pulmonary embolism. |
| Key words: Color Doppler Ultrasound-guided Inferior vena cava filter Ward bedside |
