500例Budd-Chiari综合征介入治疗并发症分析  

Analysis of complications in interventional therapy of 500 cases with Budd-Chiari syndrome

作　　者：顾玉明[1] 祖茂衡[1] 徐浩[1] 李国钧[1] 张庆桥[1] 魏宁[1] 

机构地区：[1]徐州医学院附属医院介入放射科,221002

出　　处：《中华放射学杂志》2003年第12期1083-1086,共4页Chinese Journal of Radiology

摘　　要：目的　探讨Budd Chiari综合征 (BCS)介入治疗术中及术后并发症发生的原因及预防措施。方法　 1990～ 2 0 0 2年接受介入治疗的BCS患者共 5 0 0例 ,其中腔静脉阻塞型 337例、肝静脉阻塞型 77例、混合型 86例。所有病例均行经皮穿刺球囊扩张术 (PTA) ,其中 12 0例还做了血管内支架置入术。结果　发生介入治疗并发症共 5 8例 (11 6 % ) ,死亡 1例 (0 2 % )。术中并发症有误穿心包和心包填塞 9例 (1 8% ) ,其中心包填塞 3例 (死亡 1例 ) ;金属内支架脱落入右心房 2例 (0 4 % ) ;胸腔出血 1例 (0 2 % ) ;腹腔出血 2例 (0 4 % )。术后并发症为急性再狭窄 2 7例 ,其中单纯PTA后 2 2例(5 8% ,2 2 / 380 ) ,PTA +内支架置入术后再狭窄 5例 (4 2 % ,5 / 12 0 )。穿刺部位形成假性动脉瘤 3例(0 6 % ) ;穿刺点出血和局部血肿形成 10例 (2 0 % ) ;穿刺侧下肢静脉血栓形成 4例 (0 8% )。结论　介入治疗BCS是 1种安全有效的方法 ,应采取各种有效措施避免和减少并发症的发生。Objective To discuss the causes and preventive measures of the peri- and postoperative complications of interventional therapy in treating Budd-Chiari syndrome (BCS). Methods From 1990 to 2002, a total of 500 cases with BCS treated with interventional therapy were included in this study. 120 of them received both percutaneous transluminal balloon dilatation and endovascular stent (PTA+stent), and the other 380 cases were treated by percutaneous transluminal balloon dilatation (PTA) alone. Results The incidence of complication was seen in 58 cases (11.6%), and the death rate was 0.2% in the interventional therapy of BCS. The perioperative complications included puncture into pericardium (n=9, 1.8 %), including 3 cases with pericardial effusion (one died); migration of the stent into the right atrium (n=2, 0.4%); thoracic hemorrhage (n=1, 0.2 %), and abdominal hemorrhage (n=2, 0.4 %). The postoperative complications included acute restenosis of the treated vessel formation (n=27) including 22 cases (5.8%, 22/380) in simple PTA and 5(4.2%, 5/120) after PTA+stent, pseudoaneurysm (n=3, 0.6 %), hematoma (n=10, 2.0%) at the puncture site, and thrombosis of the limb (n=4, 0.8 %). Conclusion The interventional therapy of BCS is a safe and effective method. Effective measures should be taken to evade and reduce the occurrence of the complications.

关 键 词：BUDD-CHIARI综合征 介入治疗 并发症 原因 预防 血管内支架置入术 

分 类 号：R657.3[医药卫生—外科学]