可回收支架联合搅拌溶栓、球囊扩张治疗布加综合征合并下腔静脉血栓  

Efficacy of retrievable stents combined with agitation thrombolysis and balloon angioplasty for treatment of Budd-Chiari syndrome complicated with inferior vena cava thrombosis

作　　者：吴正阳[1] 毕永华[1] 任建庄[1] 丁鹏绪[1] 周朋利[1] 张文广[1] 焦德超[1] 韩新巍[1] WU Zhengyang;BI Yonghua;REN Jianzhuang;DING Pengxu;ZHOU Pengli;ZHANG Wenguang;JIAO Dechao;HAN Xinwei(Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院放射介入科

出　　处：《郑州大学学报（医学版）》2019年第5期654-657,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(81501569)

摘　　要：目的:分析采用可回收支架联合搅拌溶栓、球囊扩张治疗布加综合征(BCS)合并下腔静脉(IVC)血栓形成的效果。方法:针对40例BCS合并IVC血栓形成的患者,对闭塞的IVC采用球囊预扩张部分恢复IVC管腔,以顺利放置可回收支架,然后进行搅拌溶栓。血栓消失后取出支架,必要时采用大球囊扩张。术后采用彩色多普勒超声检查观察IVC通畅程度。结果:所有患者均成功进行可回收支架置入、搅拌溶栓和球囊扩张,支架置入后IVC均立即恢复通畅。1例支架放置6 h后死于急性肺栓塞,1例出院0.4个月后死于冠心病,1例出院0.8个月后死于肝功能衰竭。37例支架放置8~29 d后取出,取出技术成功率为97.3%(36/37),1例因支架断裂改用外科手术取出。34例成功随访,初次通畅率和二次通畅率分别为94.1%(32/34)和97.1%(33/34),术后5 a和10 a生存率分别为89.5%和67.1%。结论:可回收支架联合搅拌溶栓、球囊扩张治疗BCS合并IVC血栓形成安全、有效,远期疗效良好。Aim:To analyze the efficacy of retrievable stents combined with agitation thrombolysis and balloon angioplasty for the treatment of Budd-Chiari syndrome(BCS)complicated with thrombosis of inferior vena cava(IVC).Methods:For 40 patients with BCS complicated with IVC thrombosis,balloon pre-dilatation was used to restore IVC lumen in the occluded IVC,so as to place the retrievable stent smoothly,and then stirring thrombolysis was performed.After the thrombus disappeared,the stent was removed and large balloon dilatation was used if necessary.The patency of IVC was observed by color Doppler ultrasonography after operation.Results:All patients were successfully treated with retrievable stent implantation,and agitation thrombolysis and balloon angioplasty.IVC recovered immediately after stent implantation.One died of acute pulmonary embolism 6 hours after stent placement,one died of coronary heart disease 0.4 months after discharge,and one died of liver failure 0.8 months after discharge.A total of 37 stents were removed after 8 to 29 days of stent placement.The successful rate of stent removal was 97.3%(36/37).One stent was removed surgically because of stent rupture.Thirty-four cases were followed up successfully.The first patency rate and the second patency rate were 94.1%(32/34)and 97.1%(33/34),respectively.The 5-year and 10-year survival rates were 89.5%and 67.1%,respectively.Conclusion:The retrievable stents combined with agitation thrombolysis,balloon angioplasty are safe and effective in the treatment of BCS complicated with IVC thrombus,with a satisfactory long-term efficacy.

关 键 词：布加综合征 可回收支架 下腔静脉血栓形成 球囊扩张成形术 搅拌溶栓 

分 类 号：R575[医药卫生—消化系统]