介入治疗布-加综合征883例体会

目的总结介入治疗布-加综合征（BCS）的临床经验及存在的问题。方法对883例BCS患者行下腔静脉（IVC）造影,确定病变部位、类型,再用硬导丝或Rups100穿刺针穿通阻塞部位、球囊扩张,对短段狭窄或闭塞、扩张后球囊有切迹的隔膜型和长段狭窄型常规放置腔静脉支架。结果本组883例,扩张成功803例,其中IVC747例,肝静脉（HV）56例,放置IVC支架504例,HV支架16例。本组46例需行附加降低门脉高压手术。术后发生急性肾衰8例,肝昏迷2例,急性心衰43例。并发IVC急性血栓形成5例,死亡2例。673例获随访7～124个月,复发31例。结论介入治疗BCS具有安全、有效、恢复快等优点,逐渐成为临床首选。

Interventional treatment for Budd-Chiari syndrome:reports of 883 cases

Objective To evaluate the clinical experiences of interventional therapy for Budd-Chiari syndrome.Methods IVC venography was first carried out and the obliterated or stenosed IVC was opened or dilated with the hard guide wire or Rups100 puncture needle and balloon,then a stent was implanted routinely for the type of obliteration or stenosis.Results The procedure was successful in 803 out of 883 cases including IVC intervention in 747 cases,and hepatic vein intervention in 56 cases.IVC stent was used in 504 cases and hepatic vein stent in 16 case.There was no sign of pulmonary embolism whereas acute renal failure occurred in 8 cases,hepatic coma in 2 cases and acute heart failure in 43 cases.Two patients died in this group and 5 were complicated with acute IVC thrombosis.Follow up of 7-124 months was performed in 673 cases with recurrence found in 31 cases.Conclusion Interventional therapy is a safe,effective and faster recovery is achieved for most types of BCS and it gradually became the first choice of treatment.