下腔静脉扩张、内置支架联合脾肾分流术治疗Budd-Chiari综合征

目的: 评价下腔静脉扩张、内置支架联合脾肾分流术治疗下腔静脉节段性病变伴肝静脉闭塞型Budd-Chiari(布-加)综合征的疗效。方法: 布-加综合征14例采用本术式治疗.其中2例下腔静脉仅轻度狭窄只行经皮下腔静脉扩张成形术,然后行脾肾分流术。结果: 无手术死亡及肝性脑病发生.2例术后发生肝功能衰竭自动出院.下腔静脉压力和门静脉压力分别由术前16~23 cmH₂O和28~43 cmH₂O降为术后9~14 cmH₂O和20~28 cmH₂O.随访12例,随访时间12~38个月,无腹胀、腹腔积液及下肢凹陷性水肿。结论: 下腔静脉扩张、内置支架联合脾肾分流术是下腔静脉节段性病变伴肝静脉闭塞型布-加综合征较好的选择.该法创伤小,疗效确切。

Inferior vena cava dilatation and stent implantation combined with splenorenal shunt to treat Budd-Chiari syndrome

Objective:To evaluate the effect of inferior vena cava (IVC) balloon dilatation and stent implantation combined with splenorenal shunt in treatment of Budd-Chiari syndrome(BCS).Methods:Fourteen cases with IVC localized lesions and hepatic vein occlusion type of BCS underwent IVC balloon dilatation and stent implantation combined with splenorenal shunt.Two cases with minor IVC stenosis only underwent percutaneous transluminal venoplasty,and then received splenorenal shunt.Results:No operation death or hepatic encephalopathy occurred.Two cases developed hepatic failure postoperatively.The IVC pressure declined from 16-23 cmH_(2O) to 9-14 cmH_(2O),and the portal venous pressure declined from 28-43 cmH_(2O) to 20-28 cmH_(2O).Twelve cases were followed up for 12 to 38 months.No abdominal distention,ascites or pitting edema in lower extremities appeared.Conclusions:IVC balloon dilatation and stent implantation combined with splenorenal shunt is the better procedure for some pathological types of BCS.It causes minor injury and has definitive effect.