球囊扩张合并支架置入治疗肝静脉阻塞型布-加综合征疗效观察  

Treatment of Budd-Chiari syndrome by hepatic vein occlusion and stent replacement

作　　者：殷占新[1] 韩国宏[1] 王建宏[1] 何创业[1] 孟祥杰[1] 孙安华[1] 丁杰[1] 吴开春[1] 樊代明[1] 

机构地区：[1]第四军医大学西京医院消化疾病研究所,西安710032

出　　处：《中华消化杂志》2008年第3期157-159,共3页Chinese Journal of Digestion

摘　　要：目的观察球囊扩张合并支架置人治疗单纯肝静脉阻塞型布-加综合征（Budd-Chiarisyn—drome，BCS）的疗效。方法2001年7月至2006年9月采用多普勒超声引导下经皮经肝穿刺肝静脉并肝静脉造影术、经颈静脉行肝静脉成形术、肝静脉球囊扩张及支架置人术治疗肝静脉阻塞型BCS患者43例。结果术前43例肝静脉平均压力为32．5cmHz0（1cm H2O=0．098kPa），支架置人后立刻下降为20cmH2O（t=11．5，P〈0．01），再次肝静脉造影显示肝静脉支架通畅，肝内肝静脉侧支消失。其中38例症状立刻消失，5例部分好转。术后43例随访期间（1～62个月，平均31．5个月），1例出院后1个月因上消化道大出血死亡，其余42例症状体征均无再发，术后多普勒超声检查肝静脉均通畅。治疗成功率为100％，所有患者均未出现严重并发症。结论多普勒超声引导下经皮经肝穿刺肝静脉和经颈静脉途径开通肝静脉，球囊扩张成形及支架置人治疗单纯肝静脉阻塞型BCS安全、有效。Objective To evaluate the effect of hepatic vein occlusion and stent replacement in treatment for Budd-Chiari syndrome（BCS）. Methods Forty three patients with BCS were underwent percutanous puncture, radiography, transjugular angioplasty, balloon dilation and stent placement for hepatic vein under Doppller ultrasounographic guidance from July 2001 to September 2006. Results Technical success was 100% with no complications. The medium vein pressure was reduced from 32.5 to 20 cm Hz O （1 cm HzO = 0. 098 kPa） after stents replacement （P 〈 0.01）. The hepatic vein angioplasty revealed that all stents were patent and branches were disappeared. The symptoms in 38 patients were disappeared immediately, and improved in 5 patients. All patients were followed up of 32 months （ranged 1-62）. Except one patient died of severe gastric bleeding, the 42 patients were survived with symptoms free. Conclusion Hepatic vein occlusion and stent replacement are safe and effective in treatment of BCS.

关 键 词：布-加综合征 放射照射术 介入 支架 

分 类 号：R686[医药卫生—骨科学]