布加综合征合并肝静脉血栓介入治疗的疗效观察  

Clinical evaluation of interventional treatment for Budd-Chiari syndrome with hepatic vein thrombosis

作　　者：张庆桥[1] 祖茂衡[1] 徐浩[1] 顾玉明[1] 魏宁[1] 许伟[1] 崔艳峰[1] 刘洪涛[1] 王文亮[1] 

机构地区：[1]徐州医学院附属医院介入放射科,221002

出　　处：《中华放射学杂志》2011年第7期666-669,共4页Chinese Journal of Radiology

基　　金：国家“十一五”科技支撑计划基金资助项目（2006038073024）

摘　　要：目的评价布加综合征合并肝静脉血栓介入治疗的临床效果。方法25例布加综合征合并肝静脉血栓形成的患者，均施行经导管尿激酶溶栓术、球囊扩张术和（或）支架置入术，术后随访采用肝脏超声检查，观察肝静脉、下腔静脉通畅情况及血栓有无复发。介入治疗前后肝静脉-有心房、下腔静脉-右心房压差的比较采用配对t检验。结果治疗成功23例，其中血栓完全溶解18例，部分溶解5例，肝静脉及下腔静脉血流通畅，肝静脉-有心房压差南术前平均（29±7）cmH2O（1cmH2O=0．098kPa）下降至术后平均（8±3）cmH2O（t=13．7，P〈0．01），下腔静脉-右心房压筹南术前平均（19±4）cmH：0下降至术后平均（5±2）cmH2O（t=13．3，P〈0．01）；不成功2例。23例患者随访1～42个月，平均（18±10）个月，死亡1例，肝静脉冉狭窄2例，经冉次球囊扩张治疗成功，其余20例无肝静脉再狭窄及血栓复发。结论布加综合征合并肝静脉血栓的介入治疗可取得较好临床效果，，Objective To evaluate the effect of interventional therapy for Budd-Chiari syndrome with hepatic vein thrombosis. Methods Twenty-five patients with Budd-Chiari syndrome complicated with hepatic vein thrombosis underwent catheter-directed urokinase thrombolysis, balloon dilation and/or stent placement. During follow-up, re-thrombosis and patency of the recanalized hepatic vein and inferior vena cava were evaluated by liver ultrasound. The pressure gradient of hepatic vein-right atrium or inferior vena cava-right atrium before and after interventional treatment was compared with paired t-test. Results Technical success was obtained in 23 patients. Complete resolution and partial resolution of the thronlbi were accomplished in 18 cases and 5 cases, respectively. The recanalized hepatic veins and inferior vena cava were patent. The mean pressure gradient of hepatic vein-right atrium dropped from （29 ± 7） cmH2O to （8 ± 3） cm H2O （1 cm H2O= 0. 098 kPa） after the interventional treatment （ t = 13.7, P 〈 0. 01 ）. The mean pressure gradient of inferior vena cava-right atrium dropped from （ 19 ±4） cmH2O to （5 ±2） cm H2Oalter the interventional treatment （t = 13.3, P 〈 0. 01 ）. Failures occurred in 2 patients. Over the follow-up period of 1 to 42 months I （ 18 ± 10） months] after interventional treatment in the 23 patients, one late death occurred. Restenoses of hepatic veins were found in 2 patients, which were all redilated successfully. Neither restenosis of hepatic vein nor recurrence of thrombosis was found in the other 20 patients. Conclusion lnterventional therapy could be effectively performed for the treatment of Budd-Chiari syndrome with hepatic vein thrombosis.

关 键 词：肝静脉血栓形成 血管成形术 放射学 介入性 

分 类 号：R575[医药卫生—消化系统]