论文部分内容阅读
目的探讨不同类型下腔静脉阻塞型Budd-Chiari综合征(BCS)介入治疗方法,评价介入治疗BCS的价值。方法86例BCS患者均由DSA确诊,根据不同类型下腔静脉阻塞采用的介入治疗方法有下腔静脉经皮单纯球囊扩张成形术;球囊扩张术加支架置入术,血栓抽吸和溶栓术。结果56例下腔静脉膜性阻塞中54例完全开通,1例因隔膜太坚硬未能扩开,1例胸段下腔静脉破裂出血。15例下腔静脉节段性阻塞中14例获得良好开通,1例因闭塞段太长(约6 cm)开通未成功。6例下腔静脉内伴有新鲜血栓完全清除后获得开通;11例下腔静脉内伴有陈旧性附壁血栓10例获得开通。介入治疗BCS成功率95.8%(68/71,肝静脉型及混合型BCS除外),死亡率1.4%,复发率4.2%,未发生心包填塞、支架滑移、肺栓塞等严重并发症。结论介入治疗BCS是一种简单、创伤小、见效快的方法,绝大部分可替代外科手术治疗。对不同类型下腔静脉阻塞采用正确的治疗方法可减少并发症和复发率。
Objective To investigate the interventional treatment of different types of inferior vena cava occlusive Budd-Chiari syndrome (BCS) and evaluate the value of interventional therapy for BCS. Methods Eighty-six patients with BCS were diagnosed by DSA. According to different types of IVC occlusion, IVC balloon angioplasty was performed. Balloon dilatation plus stent implantation, thrombus aspiration and dissolution Hysterectomy. Results In 56 cases of inferior vena cava membranous obstruction, 54 cases were completely opened. One case failed to expand due to too hard diaphragm, and one case had thrombosis and rupture of inferior vena cava. In the 15 cases of inferior vena cava segmental obstruction in 14 cases achieved a good opening, a case of occlusion due to too long (about 6 cm) opened unsuccessful. 6 cases of inferior vena cava with complete removal of fresh thrombus obtained after opening; 11 cases of inferior vena cava with old clot thrombosis in 10 cases opened. The success rate of interventional BCS was 95.8% (68/71, except for hepatic vein and mixed BCS), the mortality rate was 1.4% and the recurrence rate was 4.2%. There was no serious complications such as pericardial tamponade, stent slippage and pulmonary embolism. Conclusion Interventional treatment of BCS is a simple, less traumatic and quick method, the vast majority can replace surgical treatment. The correct treatment for different types of IVC occlusion can reduce complications and recurrence rates.