【摘要】 目的 探讨急性深静脉血栓形成时手术取栓及术前放置下腔静脉滤器的必要性。方法 手术取栓15例，均为左下肢发病，9例呈极度肿胀、疼痛剧烈、皮温下降。14例术前放置下腔静脉滤器。结果 1例取栓失败;术后静脉造影示4例深静脉全程基本通畅、6例为髂静脉短段闭塞、余呈全肢型静脉血栓。术后随访除2例仍有明显下肢肿胀外，其余病例无明显肿胀、浅静脉曲张、溃疡等，在循序减压护套的支持下能正常生活或工作。结论 对急性深静脉血栓形成取栓是必要的，术后通畅率有待进一步提高。

    关键词 急性深静脉血栓形成 手术取栓 下腔静脉滤器

    Surgical treatment of acute deep venous thrombosis of lower limbs

    Lu Min，Zhu Wenxia，Huang Xingtian，et al.

    Department of Vascular Surgery，The9th People′s Hospital Affiliated to Shanghai Second Medical University，Shanghai200011

    【Abstract】 Objective To assess the importance of thrombectomy on patients with acute deep venous thromˉbosis of lower extremities，and importance of vena caval filter implantation before thrombectomy.Methods 15cases were treated with thrombectomy，among them14cases were implanted vena caval filter before operation.Results 1case was technically failed.Postoperative phlebography showed venous recanalization in4cases;recurrent thrombosis in iliac segment in6;still occluded deep vein in another5.All patients were evenful with no pulmonary thrombosis occurred during and after operation.Conclusion Surgical thrombectomy is necessary and important in treatment of aˉcute deep venous thrombosis of lower extremity.Vena caval filter implantation before operation can help prevent from fatal pulmonary thrombosis. ......