摘要
目的 评价肝静脉阻塞性Budd Chiari综合征 (HVBCS)的介入治疗方法及效果。方法 83例HVBCS患者经历了下腔和肝静脉造影 ,71例实施介入治疗。结果 83例HVBCS分为中央性肝静脉阻塞 (COHV ,n =65 )和广泛性肝静脉阻塞 (EOHV ,n =18)两型。 65例COHV型皆成功地实施了PTA(n =46)和支架 (n =19)治疗 ,64例术后症状消失或明显改善。 6例EOHV型接受TIPS治疗 ,术后症状明显改善 4例 ,2例发生了分流道再狭窄。结论 COHV型适应于PTA和支架治疗 ,疗效满意 ;EOHV型可采用TIPS治疗 ,长期疗效尚不够满意。
Objective To evaluate the effect of interventional therapy for Budd-Chiari syndrome with hepatic vein obstruction (HVBCS). Methods Eighty-three patients of HVBCS underwent inferior vena cava and hepatic venography. PTA, PTA and stenting, and transjugular intrahepatic portosystemic shunt (TIPS) were used for treatment in 71 patients. Results All patients were divided into two types, those with central obstruction of hepatic veins (COHV, n =65),and those with extensive obstruction of hepatic veins (EOHV, n =18). Hepatic vein PTA alone ( n =46) or PTA and stenting ( n =19) were successfully performed in all patients of COHV. The symptoms and signs disappeared or markedly alleviated in 64 of 65 (99.2%) patients. During a 12-118 month follow up (mean 67 months), recurrence occurred in a total of 9 patients. Seven patients treated with PTA alone were treated again by stent placement. In 2 patients treated initially with stent placement, one underwent further PTA through the stent and the other failed to treat. TIPS placement was successful in all 6 consenting patients with EOHV. Clinical symptoms and signs showed dramatic improvement in 4 of 6 patients. Restenosis of the shunt developed in 2 patients during follow up. No serious procedure-related complications occurred. Conclusion PTA or PTA and stenting are choices for treatment of the COHV with excellent results. TIPS placement can be offered as a modality for treatment of the EOHV, with common results.
出处
《中国医学影像技术》
CSCD
2004年第10期1588-1591,共4页
Chinese Journal of Medical Imaging Technology
关键词
肝静脉血栓形成
血管成型术
支架
经颈静脉肝内门腔分流术
Hepatic vein thrombosis
Angioplasty
Stents
Transluminal-transjugular intrahepatic portosystemic shunt
