介入治疗布加综合征312例经验

目的　总结球囊扩张及支架治疗布加综合征 (Budd Chiarisyndrome ,BCS)的经验。方法　对 312例BCS患者行下腔静脉 (inferiorvenacava ,IVC)造影 ,确定病变部位、类型 ,再用导丝硬头或穿刺针穿通阻塞部位、球囊扩张、内置支架。结果　本组 312例 ,扩张成功 2 71例 ,其中IVC 2 6 0例 ,肝静脉 (hepaticvein ,HV) 11例 ,放置IVC支架 195例 ,HV支架 1例 ,无一例发生肺栓塞。术后发生急性肾衰 6例 ,肝昏迷 1例 ,急性心衰 2 1例 ,死亡 1例。并发IVC急性血栓形成 2例 ,死亡 1例。 2 0 3例获随访 6～ 10 4个月 ,复发 2 1例。结论　介入治疗BCS适应于多种病理类型 ,安全、有效。

Interventional treatment of Budd-Chiari syndrome:report of 312 cases

Objective To evaluate interventional therapy for Budd-Chiari syndrome. Methods IVC venography was first carried out, the obliteration or stenosis in the IVC was opened or dilated with the hard tip of guid wire or puncture needle and balloon, then a stent was implanted. Results The procedure was successful in 271 out of 312 cases including IVC intervention in 260 cases, and hepatic vein intervention in 11 cases. IVC stent was used in 195 cases and hepatic vein stent in 1 case. There was no pulmonary embolism happened, acute renal failure occurred in 6 cases, hepatic coma in 1 case and acute heart failure in 21 cases. One patient died in this group and 2 were complicated with acute IVC thrombosis. Follow up of 6 to 104 mos was made in 203 cases with recurrence found in 21 cases. Conclusion Interventional therapy is indicated for most types of BCS with safe and effective results.