大球囊扩张治疗下腔静脉节段型Budd-Chiari综合征探讨

目的观察大球囊扩张血管成形术治疗下腔静脉节段阻塞弄Budd—Chiari syndrome（SOVC，Segmental obstruction of the IVC）前后血流动学变化，探讨其安全性，疗效和并发症。方法SOVC患者38例，在DSA监视下，先用小球囊预扩张，后以直径25mm～30mm大球囊治疗性扩张下腔静脉。结果26例患者成功血管成形治疗，病变血管内径，术前277±232mm，术后即刻16.88±2.99mm，一月后10.61±2.45mm；病变远心段JVG压力：术前33.73±824cmH2O，术后12.77±2.79cmH2O；侧枝循环显影基本消失。随访6月～6年4个月，复发率19.23％。结论大球囊扩张血管成形术治疗SOVC，安全，有效，术后近期病变血管回缩是影响其远期疗效主要因素之一。

The treatment for segmental obstruction of the inferior vena cava by dilation with bigger balloon

Objective To observe the hemdynamic change of patients with segmental obstruction of the inferior vena cava by dilation with bigger balloon and study its safety,clinical therapeatic effects and complications.Methods：Thirty-eight patients with segmental obstruction of the inferior vena cava were treated by interventional therapy.The diameter of the balloon catheters were 25-30mm.Results：Twenty-eight patients were dilated successfully.The inside vascular diameter was 2.77±2.32mm in the pre-operation,16.88±3.99mm post-operation and 10.61±2.45mm after 4 weeks.The pressure of IVC was 33.73±8.24cmH2O in the pre-operation and 12.77±2.79cmH2O in the post-operation.Collateral circulation of arm disappeared mostly or decreased markedly after operation.Follow-up 6 months～6.3 years,recrudescence rate was 19.23%.Conclusion It is safe,efficient,rare side-effect and low recurrent to treat SOVC with bigger balloon,and shrinkage after dilation with bigger balloon.