下腔静脉滤器使用的单中心趋势分析
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1.南京医科大学附属常州第二人民医院 介入血管科 江苏 常州;2.通讯作者:贾中芝,邮箱:jiazhongzhi@com;3.王凯;4.南京医科大学附属常州第二人民医院

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常州市高层次卫生人才培养工程 (2022CZLJ026)


The Use of Inferior Vena Cava Filter: A Single Institution StudyQin Lihao, Piao Zeyu, Tian Feng, Li Shaoqin, Jia Zhongzhi, Wang Kai
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Nanjing Medical University

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    摘要:

    目的:分析单中心下腔静脉滤器(IVCF)的使用数据,了解IVCF的使用情况及存在的问题。方法:回顾性分析2016年1月至2021年9月期间,我院IVCF的使用情况,建立数据库并对数据进行分析。结果:共置入752枚IVCF,均为可回收型,置入的适应证包括:仅DVT (游离血栓/大量急性血栓)为528例(70.2%)、DVT合并肺栓塞(PE)为126例(16.8%)、仅症状性PE为98例(13.0%)。752枚IVCF中,取出470枚,取出率为62.5%,平均体内留置时长为23±33天(0~530天)。不同的患者年龄、不同的置入年份、不同IVCF品牌取出率差异均具有统计学意义(P<0.05)。未取出的282枚IVCF中,未取出前三位原因分别是:晚期肿瘤(31.2%)、仍存在放置IVCF的适应证(28.7%)、高龄(27.7%)。结论:不同年龄段的患者IVCF置入的适应证存在差异;IVCF的取出率逐年增高;IVCF的低取出率与晚期肿瘤、高龄、IVCF品牌、置入的适应证、置入年份相关,应根据不同适应证合理选择IVCF,审慎地评估长期留置IVCF的获益与风险,提高IVCF的取出率。

    Abstract:

    Objective: To analyze the data of inferior vena cava filter (IVCF) in a single-center, and to analysis the problems during the use of IVCF. Methods: Retrospectively analyze the use of IVCF in our hospital from January 2016 to September 2021. Results: A total of 752 IVCFs were implanted, all of which were retrievable. The indications for IVCF implantation including: deep venous thrombosis (DVT, free thrombosis/large acute thrombosis) in 528 cases (70.2%), DVT with pulmonary embolism (PE) in 126 cases (16.8%), and only symptomatic PE in 98 cases (13.0%). Among the 752 IVCFs, 470 were retrieved, with a retrieve rate of 62.5%, and the average indwelling time was 23 ± 33 days (0~530 days). Patient’s age, implantation years, and IVCF brands had statistically significant differences in the retrieve rate (P<0.05). Among the 282 IVCFs that were not removed, the most common reasons were: advanced tumor (31.3%), indications for IVCF still placement (28.7%), old age (27.8%). Conclusions: There are differences in the indications for IVCF placement in different age groups; the retrieve rate of IVCF is increasing; the low retrieve rate is related to malignant tumors, old age, IVCF brand, indications for still placement, and year. Also, IVCF should be selected reasonably according to indications; the benefits and risks of long-term indwelling IVCF should be carefully evaluated, and the retrieve rate needs to be increased.

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  • 收稿日期:2022-12-16
  • 最后修改日期:2023-03-18
  • 录用日期:2023-08-29
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