不同类型Budd-Chiari综合征的介入治疗(附200例分析)

目的探讨不同类型Ｂｕｄｄ－Ｃｈｉａｒｉ综合征（ＢＣＳ）介入治疗方法，评价经皮穿刺球囊扩张术（ＰＴＡ）和内支架（ｓｔｅｎｔ）治疗Ｂｕｄｄ－Ｃｈｉａｒｉ综合征的价值。材料与方法８年中诊治Ｂｕｄｄ－Ｃｈｉａｒｉ综合征患者２００例。介入治疗方法包括：下腔静脉球囊扩张术，下腔静脉球囊扩张和血管内支架放置术，经颈静脉行肝静脉成形术，经皮经肝和经颈静脉行肝静脉成形术，副肝静脉成形术，下腔静脉和肝静脉双球囊扩张术，下腔静脉和肝静脉双支架放置术。结果介入治疗ＢＣＳ的成功率为９４．４％。术中死亡率０．５％。严重的并发症为误穿心包导致心包填塞和血管内支架脱入右心房。结论ＰＴＡ和ｓｔｅｎｔ放置是一种安全、可靠的方法，可以替代外科对ＢＣＳ的治疗。

PTA and stenting for various types of Budd Chiari syndrome (analysis of 200 cases)

Purpose PTA and stenting for various types of Budd Chiari syndrome (BCS) were investigated and evaluated. Materials and methods 200 patients with BCS were diagnosed and treated in 8 years. The interventional procedures included : Percutanous balloon dilatation(PBD) of inferior vena cava (IVC) , PBD and stent placement for IVC, hepatic vein angioplasty via transjugular vein, hepatic vein angioplasty via percutanous transhepatic and transjugular approach, accessory hepatic vein angioplasty, percutanous dual balloon dilatation for IVC and hepatic vein, and percutanous dual stent placement for IVC and hepatic vein. Results The successful rate of PTA and stent placement was 94.4% and the mortality was 0.5% in this series.The restenosis rate after PTA and stent placement was 20.5% in BCS.The serious complication of PTA and stent placement of BCS was penetration into the pericadium,causing hemopericadium , and stent migration into right atrium. Conclusion PTA and stenting are safe and reliable procedures, which could replace surgery in treating BCS.