肝静脉阻塞型布—加氏综合征的介入治疗

目的:研究布—加氏综合征肝静脉阻塞的介入治疗方法,评价其治疗效果。方法:5例肝静脉型布—加氏综合征,其中男性3例,女性2例。肝静脉节段性阻塞2例,膜性阻塞2例,广泛性闭塞1例。5例均行经皮经肝穿刺肝静脉造影。采用经颈静脉途径,开通阻塞肝静脉。2例膜性阻塞的用硬质导管导丝顺行开通,2例节段性阻塞的用RUPS100肝穿装置在B超引导下,穿刺肝段下腔静脉,建立肝静脉—颈静脉导丝轨道,行球囊扩张成形或植入血管内支架治疗。1例广泛性闭塞,未行TIPSS。结果:5例患者,成功治疗4例,无严重并发症。3例实行了球囊扩张术(PTA),1例进行了血管内支架植入治疗。随访1例复发狭窄,行再次治疗。结论:肝静脉型阻塞布—加氏综合征的介入治疗应采用多途径穿刺联合破膜技术,在B超引导下可提高成功率和减少并发症;只要开通一条足够大的通道即可恢复肝静脉系统压力。

Interventional Treatment of Budd-Chiari'' Syndrome with Hepatic Vein Occlusion

Objective To study and evaluate the methods and effects of Interventional Treatment in Budd-Chiari's yndrome with hepatic vein occlusion.Methods 5 cases(male 3,female 2).2 cases with membranous webs,2 cases belongs to segmental obstruction,1 case with extensive occlusion and thrombose.4 cases treated with angioplasty and stent through guide wires built between percutanous transhepatic tracts and jugular vein guided by sonograph.Results 4 of 5 cases were treated successfully with no complication and reovered with quick reduce of signs.In follow-up 1 case recurred and the stenose was treated with PTA successlly.Conclusion Combination of multiple interventional radiological techniques and treater guided by sonograph increase success rates and reduce complications.The pressure of hepetic vein system can be reduced through only one outflow with enough diameter.