经皮球囊导管成形支架植入术治疗布-加综合征的临床观察

目的 探讨经皮下腔静脉球囊成形加支架植入术治疗布加综合征(BCS)的临床疗效。方法 120例患者均经彩色多普勒超声、下腔静脉及肝静脉造影等检查明确诊断，并进行经皮下腔静脉球囊成形(PTA)加支架植入术(EMS)治疗。所有病例随访6-108个月。结果 扩张前静脉狭窄段内径0-6mm(平均3mm)，肝静脉内径2mm。扩张并置放血管内支架后，腔静脉、肝静脉内径分别为18—20mm和8mm。扩张前下腔静脉至右房压力差为18-35cmH20(1．76-3．43Da)，平均20．3cmH20(1．989kPa)，扩张后压差消失，119例手术顺利，1例左肝静脉轻度损伤。术后96例主要症状及体征消失或基本消失，19例明显改善。120例(100％)获1-108(平均67．35)个月随访，其中门5例在随访期间血管内支架形态良好，支架内血流通畅；3例在术后8，11，16个月发生腔静脉再阻塞，经二次PTA EMS治愈；2例于术后2—3个月发生3支肝静脉再阻塞，转为外科手术。结论 经皮下腔静脉球囊成形、支架植入术是非长段阻塞型布—加综合征良好的治疗方法。

Treatment of Budd- Chiari syndrome with percutaneous transluminal angiography and expandable metallic stent

Objective To study the therapeutic effect of percutaneous transluminial angiography (PTA) and expandable metal stent (EMS) on the treatment of Budd Chiari syndrome(BCS). Methods One hundred and twenty patients with BCS confirmed by color Doppler ultrasonography, inferior vena cava venography and hepatic veins venography. All the 120 patients underwent PTA and EMS. All the 120 patients were followed up for 6 to 108 months. Results The treatment results in 115 patients(95.8%) were satisfactory,and 5 cases had recurrent during follow up . Conclusions PTA with EMS is an excellent method to treat the cases of BCS with non long segment occlusion of IVC.