Budd-Chiari综合征伴下腔静脉混合型血栓机械性抽吸联合溶栓疗效分析  

Curative effect analysis of mechanical thrombus aspiration combined with thrombolytic therapy for Budd-Chiari syndrome associated with mixed type of inferior vena cava thrombosis

作　　者：吴康[1] 许伟[1] 祖茂衡[1] 徐浩[1] 顾玉明[1] 王丹[1] 宗迎迎 万豪光[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：《介入放射学杂志》2016年第6期534-538,共5页Journal of Interventional Radiology

基　　金：江苏省科技创新与成果转化专项基金(BL2012021)

摘　　要：目的比较机械性血栓抽吸联合导管溶栓与单纯导管溶栓治疗Budd-Chiari综合征(BCS)伴下腔静脉(IVC)混合型血栓的效果。方法回顾性分析43例BCS伴IVC混合型血栓患者临床资料。根据治疗方法分为研究组(n=22,机械性血栓抽吸后辅以尿激酶溶栓和血管成形术)和对照组(n=21,单纯尿激酶溶栓后辅以血管成形术)。结果研究组IVC-右心房压力差由术前(25.2±4.1)cm H_2O改善至术后(9.1±1.6)cm H_2O,对照组IVC-右心房压力差由术前(23.3±5.1)cm H_2O改善至术后(8.9±1.9)cm H_2O,两组间术前术后差异均有统计学意义(P<0.05);术后血栓完全溶解率分别为68.2%(15/22)和57.1%(12/21),差异无统计学意义(P>0.05)。研究组溶栓天数、尿激酶用量、并发症发生率分别为(6.4±3.4)d、(25.4±13.9)×105U、0%,低于对照组(10.3±4.1)d、(40.8±15.7)×105U、19.1%,差异均有统计学意义(P<0.05)。术后平均随访(24.5±12.7)个月,研究组和对照组再狭窄率分别为9.1%(2/22)和4.8%(1/21),差异无统计学意义(P>0.05)。结论机械性血栓抽吸联合导管溶栓治疗BCS伴IVC混合型血栓效果与单纯导管溶栓相当,但溶栓天数较少、尿激酶用量较少,并发症发生率更低。Objective To compare the effects of mechanical thrombus aspiration plus catheter directed thrombolysis and simple catheter directed thrombolysis in treating Budd-Chiari syndrome （BCS）associated with mixed type of inferior vena eava （IVC） thrombosis. Methods The clinical data of 43 BCS patients with mixed type of IVC thrombosis were retrospectively analyzed. According to the treatment methods, the patients were divided into the study group （n = 22, receiving mechanical thrombus aspiration with subsequent urokinase thrombolysis and angioplasty） and the control group （n = 21, receiving urokinase thrombolysis and angioplasty only）. Results In the study group the IVC-right atrium pressure gradient decreased from preoperative （25.2±4.1） cmH2O to postoperative （9.1± 1.6）cmH2O, while in the control group the IVC-right atrium pressure gradient decreased from preoperative （23.3±5.1）emH20 to postoperative （8.9± 1.9）emH20, the differences in both preoperative and postoperative data between the two groups were statistically significant （P〈0.05）. After the treatment, the complete dissolution rates of thrombus of the study group and the control group were 68.2% （15/22） and 57.1% （12/21） respectively, the difference was not statistically significant （P〉0.05）. The thrombolysis days, the dosage of urokinase and the incidence of complication in the study group were （6.4±3.4） days, （25.4±13.9） ×105U and 0% respectively, which were lower than those of （10.3±4.1） days, （40.8±15.7） ×105U and 19.1% respectively in the control group, the differences between the two groups were statistically significant （P〈0.05）. The mean follow-up time was （24.5± 12.7） months, the restenosis rates of the study group and the control group were 9.1% （2/22） and 4.8% （1/21） respectively, and the difference was not statistically significant （P〉0.05）. Conclusion In treating BCS complicated by mixed type of IVC thrombosis, the mechanical thrombus aspiration co

关 键 词：Budd—Chiari综合征 静脉血栓形成 介入放射学 

分 类 号：R543.6[医药卫生—心血管疾病]