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目的 探讨钻挤法静脉开通术治疗完全阻塞型布 加氏综合征 (BCS)的安全性和可行性。材料与方法 2 1例完全阻塞型BCS患者 ,静脉阻塞段行钻挤法开通术。导管插入梗阻盲端的顶部 ,配合导丝探寻闭塞段潜在的腔隙 ;再旋转推进导丝 ,顺着薄弱处使其通过闭塞段。后续球囊扩张 (PTA)或内支架 (EMS)置入术。结果 肝静脉阻塞者 4例 ,下腔静脉阻塞者 11例 ,下腔静脉合并肝静脉阻塞者 6例。膜性阻塞者 19例 ,节段性阻塞者 8例。行钻挤法开通术均成功 ,技术成功率为 10 0 %。其中肝静脉PTA术后 ,再行EMS置入术 2例。术后静脉压平均下降约 1.5kPa。阻塞段的内径扩张至 11± 3 .8mm。未发生与手术有关的并发症。结论 对完全阻塞型BCS患者的介入治疗 ,采用钻挤法静脉开通术是安全和可行的。
Objective To investigate the safety and feasibility of drilling and squeezing vein occlusion in the treatment of complete occlusive Budd-Chiari syndrome (BCS). Materials and Methods 21 cases of complete occlusion of BCS patients, vein occlusion of the line drilling and crowding open surgery. The catheter is inserted into the obturator top of the blind end, with the guide wire to explore the potential lacunae of the occlusion segment; then the guide wire is rotated to weaken it through the occlusion segment. Follow-up balloon dilatation (PTA) or stent placement (EMS). Results 4 cases of hepatic vein occlusion, 11 cases of inferior vena cava occlusion, 6 cases of inferior vena cava with hepatic vein occlusion. 19 cases of membranous obstruction, segmental obstruction in 8 cases. Line drilling and crowding method were successful, the technical success rate was 100%. Among them, hepatic vein PTA surgery followed by EMS implantation in 2 cases. Postoperative venous pressure decreased by an average of about 1.5kPa. The internal diameter of the occlusion segment expanded to 11 ± 3 .8 mm. No surgery-related complications occurred. Conclusion For interventional therapy of patients with completely occluded BCS, it is safe and feasible to use drilling and crowding venous opening.