摘要
目的：研究节段性狭窄闭塞Ｂｕｄｄ－Ｃｈｉａｒｉ综合征的治疗方法和如何提高其疗效。材料与方法：本组１２例，男１１例，女１例，年龄１９～５０岁，病程２月～２５年。全部病例均经彩色超声多普勒和下腔静脉造影确诊，其中下腔静脉肝段闭塞１０例，狭窄２例，狭窄闭塞长度２～１５．５ｃｍ，平均５．６ｃｍ。对完全闭塞者应用Ｂｒｏｃｋｅｎｂｒｏｕｇｈ穿刺针行闭塞段穿通术，尔后行ＰＴＡ及血管内支架置入。结果：１０例下腔静脉节段性闭塞行穿通术，ＰＴＡ及血管内支架置入均获成功；２例节段性狭窄行ＰＴＡ成功，但在１～１．５个月后发生再狭窄，经再次ＰＴＡ及血管内支架置入也获较好效果。术前后下腔静脉压力由２．８６６±０．４００ｋＰａ降至１．５３４±０．４００ｋＰａ。术后患者腹胀减轻，肝脏回缩变软，下肢水肿及静脉曲张减轻。随访１．５～２６个月，平均８．５个月，经彩超检查下腔静脉均保持通畅，仅２例发现内支架略有塌陷，但临床症状和体征比术前也有明显改善。结论：对下腔静脉节段性狭窄闭塞的介入治疗，单行ＰＴＡ容易发生再狭窄，同时置入血管内支架可防止再狭窄的发生。对下腔静脉节段性闭塞穿通术有一定难度和风险，作者强调要熟练掌握Ｂｒｏｃｋｅｎｂｒｏｕｇｈ穿刺?
We studied how to treat partial IVC stenosis or occlusion type of Budd-Chiari syndrome by interventional means,and how to make it effectively.Materials and Methods:There were 12 cases in this study,11 cases were male,1 case was female,age ranged from 19 to 50 years old.The attack periods were about 2 months to 25 years.The diagnosis was made by colour Doppler sonography and IVC venography.There were 10 cases of occlusive lesions and 2 cases of stenosis lesions in hepatic segment of inferior vena cava,the lengths of stenosis or occlusion were about 2 to 15.5cm,average 5. 6cm.We used Brockenbrough needles to recanalize the occlusive lesions and then did PTA and planted intravascular metal stents.Results:10 cases of occlusive lesions were treated by recanalization and PTA and stentplanting,they were all successful.2 cases of partial stenosis lesions treated by PTA were successful,but 1 to 1.5 months later restenosis occurred and achieved good results after repeat PTA and intravascular stent planting.The pressure in IVC decreased from 2.866±0.400kPa to 1.534±0.400kPa postoperatively.The clinical symptoms and signs of the patients were ameliorated.The periods of follow-up were 1.5 to 26 months,average 8.5 months.The patency of IVC was evaluated with color Doppler sonography.They were patency except 2 cases of mild stenosis of stents,but their clinical conditions were ameliorated postoperatively.Conclusion:Our study indicated that PTA procedure alone were not enough for treating IVC stenosis or occlusve lesions due to restenosis occurred frequently,meanwhile,planted stents could prevent restenosis.There were some difficulty and danger in recanalization procedure for partial IVC occlusive lesions,but it could be overcome if you master correct punture method using Brockenbrough needle and solid practical anatomic knowledge.
出处
《临床放射学杂志》
CSCD
北大核心
1996年第2期110-112,共3页
Journal of Clinical Radiology
关键词
布-加综合征
狭窄闭塞
介入放射学
血管成形术
Budd-Chiari syndrome Stenosis or occlusion Interventional radiology Percutaneous trasluminal angioplasty(PTA)
