上腔静脉狭窄及阻塞的介入性开通治疗：附六例报告

报告６例上腔静脉狭窄及阻塞的介入治疗结果，旨在探讨有关技术问题及评价临床疗效。６例中，男５例，女１例，年龄４８￣７４岁，均表现为上腔静脉综合征，５例为肺癌伴纵隔淋巴结转移所致，１例为纵隔淋巴瘤压迫上腔静脉。４例造影表现为重度狭窄，２例为完全性阻塞。介入治疗时，先用导丝通过梗阻段，继而用球囊导管扩张，最后导入金属内支架。结果：６例均开通成功，无重要并发症，术后临床症状明显改善，侧支静脉消失，梗阻远侧

Interventional Treatment of Superior Vena Cava Stenosis and OcclusiOn:Preliminary Results in Six Patients

Six patients with superior vena cava stenosis or occlusion were treated with inter- ventional approach.There were five men and one woman aged from 48 to 74 years(mean 5 6.5 years).Five cases were caused by lung cancer extending into the superior mediastinum,the remain-ing one was due to compression mediastinal lymphoma. Venography revealed stenosis in 4 cases and occlusion in 2 cases. After a guide wire was passed through the stricture,an angioplasty balloon was introduced and inflated inside the obstructed region,and then a mesh metallic stent was placed by transjugular approach.Technical success was obtained in all patients, no sigificant complications oc- curred.After the procedure,all patients experienced symptomatic relief of venous obstruction. The mean caval pressure before treatment was 2.89 kPa at the peripheral end of the stenotic lesion and was significantly reduced to 0.74 kPa after treatment.The follow-up period was from 3 months to 14 months,two patients died of metastasis at the 4th and 11th month after the procedure. All cases had no recurrence of superior vena cava syndrome to death,or to the present time. The resuIts of this small series suggest that combined balloon dilatation with stent placement is an effective technique for treatment of superior vena cava syndrome. This procedure is safe and easy,and can produce immedi- ate palliation of the distressing effects of venous obstruction.