肝静脉闭塞伴代偿性肝短静脉布加综合征患者的腔内治疗  

Interventional treatment for Budd-Chiari syndrome patients with hepatic vein occlusion and compensatory short hepatic vein

作　　者：李强 路平[2] 陈士新 汤祥瑞 吴光航 Li Qiang;Lu Ping;Chen Shixin;Tang Xiangrui;Wu Guanghang(Department of Intervention,3201 Hospital,Hanzhong 723000,China;Department of Cardiology,Hanzhong Central Hospital,Hanzhong 723099,China;Department of Cardiology,3201 Hospital,Hanzhong 723000,China;Department of Cardiac Surgery,Hanzhong Central Hospital,Hanzhong 723099,China)

机构地区：[1]汉中三二〇一医院介入科,陕西汉中723000 [2]汉中市中心医院心内科,陕西汉中723099 [3]汉中三二〇一医院心内科,陕西汉中723000 [4]汉中市中心医院心脏外科,陕西汉中723099

出　　处：《中国血管外科杂志（电子版）》2022年第1期56-60,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：陕西省科学技术研究发展计划项目(2012K15-02-13)。

摘　　要：目的探讨腔内治疗肝静脉闭塞伴代偿性肝短静脉布加综合征患者的疗效。方法回顾性分析2016年11月至2019年1月汉中三二〇一医院32例接受腔内治疗的肝静脉梗阻伴肝短静脉代偿性扩张布加综合征患者的临床资料,比较患者手术前后肝短静脉情况,随访术后肝短静脉和下腔静脉的通畅情况。结果围术期无严重手术相关并发症发生,2例患者术后出现穿刺点血肿。肝短静脉压力由术前(30.0±10.0)cmH_(2)O降至术后(18.6±5.7)cmH^(2)O,差异有统计学意义(t=7.817,P<0.001);其中,肝短静脉通畅患者的肝短静脉压力由术前(26.9±8.0)cmH_(2)O降至术后(17.8±4.5)cmH_(2)O(t=6.506,P<0.001),肝短静脉梗阻患者肝短静脉压力由术前(39.3±9.9)cmH_(2)O降至术后(21.1±8.1)cmH_(2)O(t=5.932,P=0.001)。患者随访12~38个月,平均(25.2±5.8)个月,术后1年、2年和3年的一期累积通畅率分别为93.8%、85.8%和78.0%,二期累积通畅率分别为96.9%、92.7%和92.7%。结论对于肝静脉广泛性闭塞伴代偿性肝短静脉布加综合征患者,腔内治疗维持肝短静脉和(或)下腔静脉通畅安全有效,值得临床推广应用。Objective To investigate the therapeutic effect of interventional therapy in Budd-Chiari syndrome patients with hepatic vein occlusion and compensatory short hepatic vein.Methods The data of 32 Budd-Chiari syndrome patients with hepatic vein obstruction and compensatory short hepatic vein who received interventional therapy in Hanzhong 3201 Hospital between October 2016 and January 2019 were analyzed retrospectively.The condition of short hepatic vein before and after operation,and the patency of short hepatic vein and inferior vena cava in the followed up after operation were compared.Results No serious surgery-related complications occurred during the perioperative period,and 2 patients developed hematoma at the puncture site after surgery.The pressure of short hepatic vein decreased from(30.0±10.0)cmH_(2)O before operation to(18.6±5.7)cmH_(2)O after operation,and the difference was statistically significant(t=7.817,P<0.001).Among them,the short hepatic venous pressure decreased from(26.9±8.0)cmH_(2)O before operation to(17.8±4.5)cmH_(2)O after operation in patients with patency of short hepatic veins(t=6.506,P<0.001)and decreased from(39.3±9.9)cmH_(2)O before operation to(21.1±8.1)cmH_(2)O after operation in patients with short hepatic vein obstruction(t=5.932,P=0.001).Patients were followed up for 12~38 months,with an average of(25.2±5.8)months.The first-stage cumulative patency rates at 1,2 and 3 years after surgery were 93.8%,85.8%and 78.0%,respectively,and the second-stage cumulative patency rates were respectively were 96.9%,92.7%and 92.7%,respectively.Conclusion For Budd-Chiari syndrome patients with hepatic vein occlusion and compensatory short hepatic vein,interventional therapy is safe and effective in maintaining patency of short hepatic vein and/or inferior vena cava,and is worthy of clinical application.

关 键 词：布加综合征 腔内治疗 下腔静脉 肝短静脉 通畅率 

分 类 号：R575[医药卫生—消化系统]