Budd-Chiari综合征的介入治疗:附 355 例报告
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冯留顺

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Interventional therapy for BuddChiari syndrome:a report of 355 cases
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    摘要:

    摘要:
    目的 探讨介入治疗在BuddChiari综合征(BCS)治疗中的作用。
    方法 355例BCS患者均行下腔静脉造影和经皮肝穿刺肝静脉造影,根据不同病变类型分别采用经皮球囊导管下腔静脉扩张成型术(PTA)或/和内支架(stent)置入术,经皮肝肝静脉开通和扩张成型术(PTRD),经颈内静脉或下腔静脉肝静脉开通和扩张成型术,经皮肝或下腔静脉副肝静脉开通和扩张成型术。
    结果 经皮球囊导管下腔静脉扩张成型术成功率96.0%(240/250 ),复发率10.0 %(24/240);经皮肝肝静脉开通和扩张成型术成功率91.4%(32/35 );经颈内静脉或下腔静脉肝静脉开通和扩张成型术成功率90.0%(18/20);经皮肝或下腔静脉副肝静脉开通和扩张成型术成功率100%(10/10);同时行经皮球囊导管下腔静脉扩张成型术和经皮肝肝静脉开通和扩张成型术30例,成功率93.3%(28/30 );经皮肝副肝静脉开通和扩张成型术及下腔静脉球囊导管下腔静脉扩张成型术(PTA)或/和内支架(stent)置入术10 例,成功率90.0%(9/10 )。严重并发症10 例,占 2.8%(10/355)。
    结论 介入治疗对某些类型BuddChiari综合征患者是一种简单、安全有效的治疗方法。

    Abstract:

    Abstract:Objective
    To investigate the effect of interventional therapy for BuddChiari Syndrome(BCS).
    Methods 355 patients with BCS were examined with phlebography of inferior vena cava(PIVC) and percutaneous transhepatic hepatovenography(PTHV).The interventional procedures were based on the pathological changes of inferior vena cava(IVC) and main hepatic veins(MHVs).The procedures included PTA and/or stent placement of IVC,percutaneous transhepatic recanalization and dilation (PTHRD)of MHVs,and percutaneous transjugular or transinferior vena cava recanalization and dilation with stent placement of MHVs(PTJRD and PTIRD ), percutaneous transhepatic recanalization or transinferior vena cava recanalization and dilation with stent placement of associated hepatic veins(AHVs).
    Results The success rate and recurrence rate were 96.0%(240/250) and 10.0 %(24/240), respectively, in PTA; the success rate was 91.4%(32/35 ) in PTHRD of MHVs; 90.0%(18/20 ) in PTJRD and PTIRD of MHVs, 100.0%(10/10) in PTJRD and PTIRD of AHVs; 90.0 %( 9/10 ) in PTA and stent placement plus PTHRD of AHVs. Severe complications occurred in 10 cases (2.8%).
    Conclusions Interventional therapy is simple, safe and effective for patients with some types of BuddChiari Syndrome.

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冯留顺 ,唐哲 ,陈孝平 ,马秀现 ,李天晓 ,许培钦. Budd-Chiari综合征的介入治疗:附 355 例报告[J].中国普通外科杂志,2005,14(2):16-.
DOI:10.7659/j. issn.1005-6947.2005.02.016

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  • 收稿日期:2004-06-10
  • 最后修改日期:2004-08-27
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  • 在线发布日期: 2005-02-25