B超引导下经皮肝穿刺肝静脉成形术 在布-加综合征介入治疗中的应用

目的 探讨B超引导下经皮肝穿刺肝静脉成形术在布-加综合征的介入治疗中的应用价值和疗效。方法 对7例下腔静脉狭窄同时合并肝静脉狭窄或闭塞的布-加综合征患者，在施行下腔静脉成形术后，采用B超引导下经皮肝静脉穿刺的方法，实施肝静脉球囊扩张术或支架植入术。结果 7例患者在单独实施下腔静脉成形术效果不显著的情况下，在B超引导下实施肝静脉成形术，2例单纯球囊扩张，5例植入支架，无严重并发症，术后腹水、下肢水肿等症状有不同程度改善。结论 B超引导下的经皮肝静脉穿刺肝静脉成形术，定位准确，实施快捷，对合并肝静脉狭窄或梗阻的布-加综合征患者症状的缓解有明显效果。

Percutanous transhepatic angioplasty of hepatic vein guided by B-ultrasound in interventional therapy of Budd-Chiari syndrome

Objective To investigate the efficacy of percutaneous transhepatic angioplasty of hepatic vein under guidance of ultrasound in the treatment of Budd-Chiari syndrome (BCS). Methods Seven BCS patients with stenosis or obstruction of both the inferior vena cava and hepatic vein were treated with balloon dilation and stents placement of hepatic vein under guidance of ultrasound after applying angioplasty/stenting of inferior vena cava. Results Successful puncture of hepatic vein under the guidance of ultrasound was achieved in all cases. Balloon dilation was performed in all 7 patients, and stenting was applied in 5 of them. The symptoms of BCS such as ascites and swollen of lower extremities were remarkably improved in all cases after angioplasty/stenting. No serious complications were noted during the follow-up. Conclusion Percutaneous transhepatic angioplasty/stenting of hepatic vein guided by ultrosound is a simple and reliable method for BCS patients with stenosis or obstruction of hepatic vein, and stenting is safe and effective in treating BCS.