《中国康复理论与实践》

《中国康复理论与实践》

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脊髓损伤后应用下腔静脉滤器的并发症分析①

张军军，程潭，周钱宏，赵冰，范宁建，卢占斌，王立功，宋海明   

  1. 河北省唐山市第二医院脊柱三科，河北唐山市063000。
  • 出版日期:2016-02-25 发布日期:2016-06-01

Complications of Inferior Vena Cava Filter Placement for Pulmonary Embolism after Spinal Cord Injury

ZHANG Jun- jun, CHENG Tan, ZHOU Qian- hong, ZHAO Bing, FAN Ning- jian, LU Zhan- bin, WANG Li- gong, SONG Hai-ming   

  1. The Third Department of Spine Surgery, the Second Hospital of Tangshan, Tangshan,Hebei 063000, China
  • Published:2016-02-25 Online:2016-06-01

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摘要： 目的探讨脊髓损伤后为防止下肢深静脉血栓(DVT)形成并发肺栓塞应用下腔静脉滤器(IVCF)后出现的严重并发症。方法回顾2014 年12 月~2015 年7 月本院急性脊髓损伤患者95 例。结果23 例出现下肢DVT，其中15 例置入IVCF，除10 例有抗凝禁忌证外，其他患者行抗凝治疗。随访观察有3 例出现严重并发症，其中2 例出现滤器以远广泛血栓形成，并发双下肢重度肿胀、肾功能不全、高血压；1 例患者出现持续高热。结论脊髓损伤并发下肢DVT后，尽管IVCF置入作为预防肺栓塞的方法被广泛应用，但应该高度重视滤器并发症的形成，滤器置入应非常谨慎。

关键词: 脊髓损伤, 深静脉血栓, 下腔静脉滤器, 并发症

Abstract: Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embolism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anticoagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension; 1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selection of IVCF and complication prevention should be taken into account.

Key words: spinal cord injury, deep venous thrombosis, inferior vena cava filter, complication