第三肝门成形术在Budd-Chiari 综合征介入治疗中的应用

目的 探讨第三肝门成形术[经皮腔内血管成形术(PTA)及支架置入术]在Budd-Chiari综合征(BCS)介入治疗中的临床应用价值。方法 本组20例BCS患者,其中男12例,女8例,年龄17～53岁,采用直接或标识下经股静脉或颈静脉第三肝门成形术,或采用Rendez-vous技术第三肝门成形术。结果 全部病例实施第三肝门靶血管PTA及支架置入术,均获得成功,未出现严重并发症。单纯PTA治疗12例,支架置入术8例(共置入支架9个)。术后随访3～54个月,临床治愈10例,有效7例,无效3例。有效率为85％。结论 第三肝门成形术作为治疗肝静脉型BCS是一种安全、有效的新方法,有着与第二肝门成形术同等的治疗价值。

Application of percutaneous transluminal angioplasty and stent placement at the third hepatic porta in treatment of Budd-Chiari syndrome

Objective To evaluate percutaneous transluminal angioplasty (PTA) and stent placement at the third hepatic porta in treatment of Budd-Chiari syndrome (BCS). Methods Twenty patients with BCS, 12 males and 8 females, aged 17 to 53, with the main clinical symptom of abdominal distention and mild abdominal pain, were treated with PTA and stent placement: after the identification of the target vessel percutaneous puncture was performed at femoral or jugular vein and rendezvous procedure was used so as to conduct PTA or place a stent. Follow-up was made for 3-54 months.Results Operation was succeeded in all patients without severe complication with a clinical effective rate of 85%. Symptoms were gradually relieved in 17 cases. Restenosis occurred in 2 cases. One patient died from severe gastric bleeding and one formed thrombosis in the stent. Conclusion A safe and effective new method for diagnosing and treating BCS, PTA and stent placement at the third hepatic porta has the same treatment value for BCS just as the operation at the second hepatic porta.