导丝贯穿技术在肝静脉型布加综合征介入治疗中的应用  

The technique of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction

作　　者：朱蕻潮 徐浩[1] 祖茂衡[1] 崔艳峰[1] 魏宁[1] 许伟[1] 张庆桥[1] 

机构地区：[1]江苏省徐州医学院附属医院介入放射科,221006

出　　处：《中华肝胆外科杂志》2015年第8期551-554,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：江苏省“十二五”科教兴卫工程创新团队资助项目（13201143）

摘　　要：目的探讨导丝贯穿技术在肝静脉型布加综合征（BCS）介入治疗中的应用价值。方法回顾性分析2011年5月至2014年8月收治的25例肝静脉型BCS患者的临床资料。所有患者均用导丝贯穿法行肝静脉成形术。介入治疗前后测量肝静脉压力，用t检验评价治疗前后肝静脉压力的变化。结果25例患者均成功用导丝贯穿法行肝静脉成形术。术中无血管破裂出血、心包填塞及肝包膜破裂出血等并发症发生。治疗后肝静脉压力由（48．3±8．0）cmH2O降至（20．9±3．8）cmH2O（t=26．82，P〈0．05），治疗前后差异有统计学意义。术后所有患者临床症状、体征均明显缓解或消失。随访期间有4例患者再次出现BCS相关症状。其中2例再次行球囊扩张治疗成功，1例因肝硬化失代偿改用经颈静脉肝内门体分流（TIPS）治疗，另1例因患强直性脊柱炎第三次症状复发行肝静脉开通治疗失败。结论采用导丝贯穿技术行肝静脉成形术治疗肝静脉型BCS是～种安全、有效的补充治疗方法，能提高肝静脉型BCS的治疗成功率。Objective To investigate the value of guide-wire loop in interventional therapy of pa- tients with Budd-Chiari syndrome with hepatic vein obstruction. Methods A retrospective study was conducted on 25 patients with Budd-Chiari syndrome （BCS） with hepatic vein obstruction treated from May 2011 to August 2014. The technique of guide-wire loop was used in these patients. The pressure of the hepatic vein was measured before and after treatment. The difference in the pressure was analyzed by the t test. Results All the patients were treated successfully using guide-wire loop angioplasty. No complications of bleeding, pericardial tamponade and liver capsule hemorrhage were observed. After treatment, the pressure of the hepatic vein reduced from （48. 3 ＋8.0） cmH20 to （20. 9 _＋3. 8） emH20 （t =26. 82, P〈0. 05） ; The symptoms and physical signs of the patients were relieved or disappeared. BCS-related symptoms reap- peared on follow-up in 4 patients, 2 were treated by balloon dilation successfully. 1 patient was treated with transjugular intrahepatie portosystemic shunt （TIPS） because of decompensated liver cirrhosis. 1 patient with ankylosing spondylitis had treatment failure and the symptoms relapsed for the third time. Conclusion The technique of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction is safe and effective, and it can improve the overall success rate of treatment.

关 键 词：布加综合征 球囊扩张术 肝静脉 介入治疗 

分 类 号：R657.34[医药卫生—外科学]