下腔静脉阻塞类型和病程对PTA治疗的影响  

The effect of Sugiura's classification and disease course in obstruction of IVC treated by percutaneous transluminal angioplasty

作　　者：杨宁[1] 刘巍[1] 高万勤 魏定夏 金征宇[1] 管珩[1] 刘昌伟[1] 牟文斌[1] 孙革利[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院,100730 [2]洛阳医专附属医院放射科 [3]新乡地区中心医院外科

出　　处：《介入放射学杂志》2000年第1期7-9,共3页Journal of Interventional Radiology

摘　　要：下腔静脉阻塞类型和病程对ＰＴＡ 治疗的影响目的　评价单纯ＰＴＡ 对治疗肝段下腔静脉阻塞综合征的长期疗效和相关因素分析。方法　１９９３～１９９７ 年间，１６ 例肝段下腔静脉阻塞患者实施下腔静脉血管成形术。术前对所有患者进行病史调查，常规临床体验，超声及下腔静脉造影，造影结果按Ｓｕｇｉｕｒａ 法分类。术后随访分为Ａ 组（ 症状复发组） 和Ｂ组（症状未复发组） 。结果　１６ 例患者中，Ａ 组７ 例，Ｂ 组９ 例，术前平均病程分别为（７ ．７１ ±３．０４） 年（４ ～１２ 年） 和（２．３３ ±１ ．５） 年（１ ～５ 年）。主要临床表现为腹胀，肝脾大，双下肢及胸腹壁静脉曲张。下腔静脉造影Ｓｕｒｇｉｕｒａ 分类：Ａ组：Ⅰａ、Ⅰｂ 、Ⅲ型各１ 例，Ⅱ型４ 例（ 肝静脉开放２ 例，闭塞５ 例）。Ｂ组：Ⅰａ、Ⅲ型各３ 例，Ⅰｂ 型２ 例，未能归类１ 例（肝静脉开放６ 例，闭塞３ 例） 。１６ 例ＰＴＡ 均获成功，除１ 例术后发生右髂股静脉血形成并发轻度的肺栓塞外，无其它并发症发生。Ａ 组症状复发平均时间（２２ ．５７ ±１２ ．８５）个月。Ｂ组无症状复发平均时间（４１．５５ ±６．２）１ 个月。结论：ＰＴＡ 对病程短。Objective To evaluate the long term curative effect of BCS treated by PTA without stenting.Methods 16 patients with suprahepatic obstruction of inferior vena cava were treated by PTA during 1993 1997.In each case,clinical history,physical examination,US & IVC angiography were investigated before PTA.The obstruction types of IVC were classified according to Sugiura's classificaton.Long term follow up was preformed dividing into grorp A(recurrence)and group B(without recurrence). Results Male 11,female 5,aged 37±9 years(range 25～53years).Group A=7 cases,Group B=9 cases,average courses of disease were (7.71±3.04) years (4～12 years)and (2.33±1.5) years(1～5years)before PTA repectively.Sugiura's classification of IVC angiography included A group,with one case each for Ⅰa, Ⅱb,Ⅲtype,4 cases for Ⅱ type(hepatic vein patention 2 cases,hepatic vein occlusion in 5 cases)Group B contained three cases each for Ⅰa and Ⅰb(hepatic vein patent in 6 cases,hepatic vein occlusion in 3 cases).All procedures were successful,with one exception of suffering from thrombosis of illiac vein and low grade embolization of pulmonary artery.Either the symptoms or signs disappeared or relieved after PTA.No severe side effects occrred.Follow up for 10 through 48 months revealed that average period of recurrence was (22.57±12.58) months in Group A and average period of no recurrence was (41.55±6.21) months in Group B.Conclusions Long term curative effect of the patient with suprahepatic obstruction of IVC treated by PTA required at least with one hepatic vein patency and short course of the disease.

关 键 词：经皮 经腔 血管成形术 下腔静脉阻塞综合征 BCS 

分 类 号：R654.4[医药卫生—外科学]