球囊扩张治疗Budd-Chiari综合征合并下腔静脉血栓形成的疗效  

Efficacy of intravenous preconditioning and phased balloon dilation in Budd-Chiari syndrome complicated with inferior vena cava thrombosis

作　　者：卢冉[1] 高涌[1] 余朝文[1] 聂中林[1] 陈世远[1] 王孝高 LU Ran;GAO Yong;YU Chaowen;NIE Zhonglin;CHEN Shiyuan;WANG Xiaogao(Department of Vascular Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院血管外科

出　　处：《皖南医学院学报》2019年第4期336-339,共4页Journal of Wannan Medical College

基　　金：安徽省科技攻关项目(1704A0802160)

摘　　要：目的:总结预开通分期球囊扩张治疗Budd-Chiari综合征合(BCS)并下腔静脉血栓形成的疗效。方法:根据溶栓前是否小球囊预扩张,分为预扩组和对照组,比较两组疗效及围手术期并发症的发生情况;分析再发狭窄血栓形成的危险因素。结果:预扩组一期血栓完全清除率高于对照组(χ2=4.68,P<0.05);预扩组溶栓治疗时间及住院时间均较对照组短(t1=6.59,t2=4.02,均P<0.01);两组间肺动脉栓塞发生率差异无统计学意义(χ^2=0.04,P>0.05)。单因素方差分析残余狭窄程度、闭塞类型是再发狭窄血栓形成的重要危险因素(χ1^2=8.05,χ2^2=5.33,P<0.05)。结论:腔内预开通分期球囊扩张治疗下腔静脉并发血栓形成安全、有效;残余狭窄、闭塞类型是复发的独立危险因素。Objective:To evaluate the efficacy of intravenous preconditioning and phased balloon dilation in the treatment of patients with Budd-Chiari syndrome complicated with thrombosis at inferior vena cava.Methods:The patients were divided into pre-expansion group and control group by the requirement of small balloon dilation before thrombolysis.The curative effect and perioperative complications were compared between groups,and the risk factors for recurrence of thrombosis were analyzed.Results:The complete clearance rate of primary thrombus was higher in the pretreatment group than in the control group(χ^2=4.68,P<0.05).Patients undergone pre-expansion had shorter duration of thrombolytic use and hospital stay than those of the control group(t1=6.59,t2=4.02,P<0.01).There was no significant difference in the incidence of pulmonary embolism between groups(χ2=0.04,P>0.05).One-way ANOVA indicated that residual stenosis and occlusion extent were significant risk factors for restenosis and thrombosis(χ1^2=8.05,χ2^2=5.33,P<0.05).Conclusion:Pre-conditioned and phased balloon dilatation is safe and effective in the treatment of thrombosis at inferior vena cava.Residual stenosis and occlusion type are independent risk factors for recurrence of stenosis and thrombosis.

关 键 词：布加综合征 腔内治疗 血栓形成 预开通 

分 类 号：R575.2[医药卫生—消化系统] R543.6[医药卫生—内科学]