Budd-Chiari 综合征根治术后复发的介入治疗:附15例报告
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张小明, Email: rmyyxgwk@163.com

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Interventional therapy for recurrence of Budd-Chiari syndrome after radical operation: a report of 15 cases
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    摘要:

    目的:探讨布加综合征(BCS)根治术后复发患者介入治疗的可行性及疗效。 方法:回顾性分析2007年3月—2013年9月15例BCS根治术后复发行介入治疗患者的临床资料。 结果:15例患者,年龄30~68岁,平均46.4岁;共行18例次介入治疗(1例3次,1例2次),其中下腔静脉球囊扩张成形术10例次,置管溶栓后下腔静脉球囊扩张成形术5例次,下腔静脉、肝静脉及副肝静脉球囊扩张成形术2例次,下腔静脉球囊扩张成形术并下腔静脉支架植入1例次。围手术期未出现肺动脉栓塞、心包填塞等并发症 。15例患者随访12~106个月,平均41.9个月,13例未出现复发症状及体征,1例肝静脉闭塞在外院行球囊扩张支架成形术,1例下腔静脉再次闭塞保守治疗。 结论:对于BCS根治术后复发患者,选择及时介入治疗安全有效,可以改善累积通畅率及预后。

    Abstract:

    Objective: To investigate the feasibility and efficacy of endovascular therapy for patients with recurrence of Budd-Chiari syndrome (BCS) after radical surgery. Methods: The clinical data of 15 patients undergoing interventional treatment for BCS recurrence after radical operation were retrospectively analyzed. Results: In the 15 patients, the age ranged from 30 to 68 (average 46.4) years; interventional procedure was performed 18 times (3 and 2 times for one case each), which included balloon angioplasty of inferior vena cava (IVC) in 10 cases, IVC balloon angioplasty after catheter direct thrombolysis in 5 cases, balloon angioplasty of IVC, hepatic vein and accessory hepatic vein in 2 cases, and IVC balloon angioplasty and stent placement in 1 case. No perioperative complication such as pulmonary artery embolism or pericardial tamponade occurred. Fifteen patients were followed up for 12 to 106 (average 41.9) months, during which time, 13 patients showed no signs and symptoms of recurrence, one patient developed hepatic venous occlusion and then underwent hepatic vein angioplasty and stenting in another hospital, and one patient developed IVC re-occlusion and received conservative treatment. Conclusion: For patients with recurrent BCS after radical operation, timely and appropriate interventional therapy is safe and effective and may improve the cumulative patency rate and prognosis.

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李清乐,曾庆福,张小明,李伟,沈晨阳,张学民,蒋京军,焦洋. Budd-Chiari 综合征根治术后复发的介入治疗:附15例报告[J].中国普通外科杂志,2014,23(12):1664-1667.
DOI:10.7659/j. issn.1005-6947.2014.12.012

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  • 收稿日期:2014-10-08
  • 最后修改日期:2014-11-20
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  • 在线发布日期: 2014-12-15