分娩後に発症した深部静脈血栓症に対して一時的下大静脈フィルターを挿入した1例

A Case of Deep Vein Thrombosis Treated with a Temporary Vena Caval Filter

　患者は30歳，女性．分娩後8日目の左鼠径部痛と左下肢の腫脹を主訴に来院した．逆行性静脈造影にて左総腸骨静脈の完全閉塞を認め，左下肢深部静脈血栓症，青股症と診断した．肺塞栓の予防のため，一時的下大静脈フィルターを右正中肘静脈より挿入した．下肢の色調は自然経過で改善したため，手術や血栓溶解は行わず，抗凝固療法のみを行った．経過は良好で，第9病日にフィルターを抜去し，第12病日に退院した．一時的下大静脈フィルターは，挿入に伴う侵襲が軽度であり，静脈壁を損傷することが少なく，抗凝固療法を併用可能で，永久型フィルターと同程度の効果が得られるなどの利点があり，今後有用な治療法となりうると考えられた．

A 30-year-old woman who delivered a healthy boy eight days previously presented with sudden onset of left inguinal pain and left lower extremity swelling. Veno-graphy revealed complete obstruction of the left corn mon iliac vein. The diagnosis of deep vein thrombosis and phlegmasia cerulea dolens of the left lower extrem ities was made. To prevent pulmonary thromboem holism, the patient underwent insertion of a temporary vena caval filter from the right cubital vein. Since the color of her leg had changed back to normal, anticoagu lation therapy only was instituted. Her hospital course was uneventful, and the filter was removed on the ninth hospital day. She was discharged on the 12 th hospital day.