第二肝门重建术治疗肝静脉阻塞型Budd-Chiari综合征  

Reconstruction of the Second Hepatic Portal in the Management of Occlusive Hepatic Vein in Patients with Budd Chiari Syndrome

作　　者：孙俊凯[1] 李欣[1] 郑传胜[1] 王勇[1] 夏向文[1] 梁惠民[1] 冯敢生[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院介入放射科,武汉430022

出　　处：《临床放射学杂志》2009年第10期1435-1439,共5页Journal of Clinical Radiology

摘　　要：目的分析和评价第二肝门重建术治疗肝静脉阻塞型布-加综合征(Buddi-Chiari syndrom,BCS)的可行性和中远期疗效。资料与方法自1999年1月至2008年12月收治的肝静脉阻塞型或肝静脉阻塞伴下腔静脉阻塞的BCS患者,单独应用副肝静脉成形术或分别联合肝静脉成形术、下腔静脉成形术的方法治疗的27例患者,在副肝静脉成形术和肝静脉成形术前后经导管测定副肝静脉、肝静脉压力,观察围手术期并发症,并观察术后6、12、24、36个月受干预血管的通畅率。结果27例中26例成功,副肝静脉成形术成功率达96%,术中3例出现心慌、胸闷症状,急性肺栓塞1例,均经保守治疗痊愈。26例随访,术后6、12、24及36个月受干预血管的初始再通率分别为96.2%、88.5%、76.9%及73.1%。结论第二肝门重建术是治疗肝静脉阻塞型BCS行之有效的方法,在肝静脉阻塞型BCS介入治疗中应灵活运用。Objective To analyze and evaluate the feasibility and the mid-to-long term therapeutic efficacy of reconstruction of the second hepatic portal for the treatment of Budd-Chiari syndrome（B-C-S） with occlusive hepatic vein.Materials and Methods All Budd Chiari syndrome patients with occlusive hepatic vein or both occlusive hepatic vein and inferior vena cava were collected and treated from Jan 1999 to Dec 2008,27 of them underwent single accessory hepatic vein PTA or combined with hepatic vein.The patients were observed for perioperative complications and were followed up for 6 month to 36 month to examine the patency rate of the targeted vessel.Results Technology achievement ratio of accessory hepatic vein PTA was 96%,symptoms of palpitation and chest distress were observed in 3 cases,acute pulmonary embolism was observed in 1 case,all patients were recovered after effective treatment,no fatal complication was observed.Patency rate of the targeted vessel were 96.2%,88.5%,76.9% and 73.1% respectively after 6 month,12 month,24 month and 36 month.Conclusion Reconstruction of the second hepatic portal is an effective therapeutic method for the treatment of Budd Chiari syndrome with occlusive hepatic vein,which should be utilized reasonably for the treatment of this syndrome.

关 键 词：布-加综合征 肝静脉阻塞 介入治疗 副肝静脉和肝静脉成形术 支架 

分 类 号：R657.3[医药卫生—外科学]