姑息性内支架置入术治疗累及右心房的恶性下腔静脉阻塞  

Malignant inferior vena cava obstruction involving right atrium: palliative treatment with self expandable metallic stent

作　　者：邵国良[1] 王建华[1] 周康荣[1] 颜志平[1] 

机构地区：[1]上海医科大学中山医院放射科,200032

出　　处：《中华放射学杂志》2001年第3期200-202,共3页Chinese Journal of Radiology

摘　　要：目的　探讨右心房及下腔静脉内联合置入内支架治疗累及右心房的恶性下腔静脉狭窄的安全性与疗效。方法　 5例男性晚期肝癌患者 ,年龄 42～ 6 5岁 ,平均 5 6 3岁。肿瘤侵及下腔静脉和右心房下腔静脉入口引起下腔静脉阻塞 ,产生肝肿大、腹水、下肢水肿等症状和体征。选用“Z”形自膨胀不锈钢内支架 ,长度 7 5～ 10 0cm ,直径 2 5cm ,将其部分置入右心房 ,大部分置入下腔静脉 ,以开通阻塞的下腔静脉 ,心腔段内支架置入长度 1～ 3cm。结果　内支架均置入成功 ,阻塞的下腔静脉全部开通。患者下腔静脉阻塞症状和体征均明显减轻或消失。随访 6 7～ 188d ,下腔静脉阻塞症状未见复发 ,也无与内支架置入有关的心脏并发症。结论　对累及右心房的恶性下腔静脉狭窄采用右心房和下腔静脉联合内支架置入术是一种安全、有效的治疗方法。Objective To investigate the safety and efficacy of placement of self expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56 3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. “Z” type stainless steel stents (7 5～10.0 cm in length and 2 5 cm in diameter) were selected for these patients. Part (1.0～3.0 cm in length ) of stent was placed in right atrium and the rest was in ICV. Results All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow up period (67～188 days). Conclusion Placement of self expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods.

关 键 词：介入性放射学 内支架置入术 恶性下腔静脉阻塞 

分 类 号：R730.5[医药卫生—肿瘤]