Budd-Chiari综合征的介入治疗
Interventional endovascular treatment of Budd-Chiari syndrome
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摘要: 目的: 总结病变段球囊扩张及内置支架治疗布-加综合征(Budd-Chiarisyndrome,BCS)的经验。方法: 对359例BCS患者行下腔静脉(IVC)或经皮肝穿肝静脉(HV)造影,确定病变部位、类型,再用导丝硬头或破膜针穿通阻塞部位、球囊扩张、内置支架。结果: 破膜扩张成功318例,其中IVC306例,HV12例。放置IVC支架232例,HV支架2例,无肺栓塞发生。术后肝昏迷1例,急性心功能不全21例。并发IVC急性血栓形成2例。248例获随访6~126个月,复发21例。结论: 介入治疗BCS微创、安全、有效,术后并发症少,恢复快,为首选治疗方法。Abstract: Objective: To summarize the experience of interventional therapy for Budd-Chiari syndrome(BCS).Methods: Inferior vera cava(IVC) and hepatic vein venography were first carried out,the obliteration or stenosis in the IVC was opened or dilated with the hard tip of guide wire or puncture needle and balloon,then a stent was implanted.Results: The procedure was successful in 318 out of 359 patients including IVC intervention in 306 patients,and hepatic vein intervention in 12 patients.IVC stent was used in 232 patients and hepatic vein stent in 2 patients.There was no pulmonary embolism happened.There were liver coma in 1 patient and acute heart dysfunction in 21 patients.Two patients were combined with acute IVC thrombosis.Follow up in 248 cases ranged from 6 to 126 months.The recurrence was found in 21 patients.Conclusions: Interventional therapy for Budd-Chiari syndrome is less invasive,safe,effective,with less complications and fast recovery and it is the first choice for BCS.