524例Budd-Chiari综合征介入治疗并发症回顾性分析  

A retrospective analysis of complications in interventional therapy for 524 patients with Budd-Chiari syndrome

作　　者：樊庆勇[1] 

机构地区：[1]山东省菏泽市立医院介入科,山东菏泽274031

出　　处：《中国临床医学影像杂志》2013年第2期104-109,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:分析Budd-Chiari综合征(BCS)介入治疗并发症的防治。方法:回顾性分析524例介入治疗BCS患者的临床资料,其中介入治疗术中及术后共发生主要并发症74例(74/524,14.1%),探讨并发症的分类、发生原因及处理方法。结果:74例介入治疗并发症患者中,死亡3例(0.57%),余均成功救治。其中术中、术后出现的主要并发症有:穿刺局部严重并发症6例;早期诊断性造影后下腔静脉内血栓形成3例;出血6例;弥散性血管内凝血2例;误穿心包16例,导致心包填塞4例(1例死亡);球囊扩张成形术(PTA)术中急性再狭窄5例,术后再狭窄17例;支架相关并发症19例,发生率13.4%,占总体并发症25.7%(19/74)。结论:介入治疗BCS创伤小、安全有效,但也存在较为严重的并发症,应采取各种措施减少和避免其发生,提高并发症的处理水平及临床成功率。Objective： To discuss the prevention and treatment of complications in interventional therapy for Budd-Chiari syndrome （BCS）. Methods： Clinical data of 524 patients with BCS treated via interventional therapy were retrospectively analyzed. Among the patients, 74 cases suffered from intraoperative and postoperative complications（74/524, 14.1%）. Types of com- plications, together with their causes and treatment methods were studied. Results： Among the 74 patients who suffered from complications, death occurred in three and successful treatment was obtained in all the other cases, with a death rate of 0.57%. The intraoperative and postoperative complications included those occurring in the puncture sites （n=6）, inferior vena cava thrombosis after early diagnostic angiography（n=3）, bleeding（n=6）, disseminated intravascular coagulation（n=2）, mistakenly puncturing into pericardium（n=16）, pericardia1 tamponade（n=4, death in one）, acute restenosis during the treatment via PTA（n= 5）, postoperative restenosis（n=17）, cases related to stents（n=19）. The incidence rate related to stents was 13.4%, which accounted for 25.7% in all the cases （19/74）. Conclusion： Interventional therapy is safe and effective for the treatment of BCS with the advantage of little trauma. However, many kinds of complications still might happen. All kinds of preventive measures should be taken to avoid or reduce the possible complications so as to improve the clinical success rate of interventional therapy.

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] R815[医药卫生—内科学]