摘要
目的:探讨节段性狭窄闭塞型Budd-Chiari综合征(BCS)的介入治疗价值及方法。方法:搜集26例BCS病例资料,其中9例为下腔静脉(IVC)节段性狭窄,17例为IVC节段性闭塞。对单纯IVC狭窄患者行球囊扩张术,对IVC节段性闭塞患者先使用导丝硬头钝性开通或TIPS穿刺针锐性开通,然后行球囊扩张术。如多次球囊扩张后IVC仍存在较严重狭窄,则置入管腔内支架(EMS)。结果:本组17例节段闭塞型BCS均一次成功开通IVC,26例共接受33次球囊扩张治疗,其中12例因仍存在较严重IVC狭窄给予EMS置入治疗。术后患者肝脾缩小,腹水消失。随访所有病例2～36个月,未见复发及消化道出血。结论:节段性狭窄闭塞型BCS介入治疗效果明确;部分节段性狭窄闭塞型BCS患者经球囊扩张后可不置入EMS,如果狭窄仍明显存在,需置入EMS。
Objective：To study the clinical value of interventional therapy for segmental stenosal-occlusive type of Budd-Chiari syndrome（BCS）.Methods ：Segmental stenosis of inferior vena cava（IVC） was found in 9 cases,segmental occlusion of IVC was found in 17 cases.Balloon dilation was carried out for patients with single stenosis of IVC.For patients with segmental occlusion of IVC,passing through with hard tip of guide wire or with sharp tip of TIPS needle was carried out first,then balloon dilation was carried out.EMS was implanted into IVC if degree of stenosis exceeded 60 percent and/or length of stenosis exceeded 2.5cm after multiple balloon dilations.Anticoagulant therapy was carried out after interventional treatment for 24 months.Results：Successful IVC passing through using guide wire was done in 17 segmental occlusion cases,33 times of balloon dilation were carried out for 26 cases,EMS implantation was done in 12 cases with severe IVC stenosis after balloon dilation.Reduction of size of liver and spleen was found,and ascites disappeared.Recurrence and alimentary tract hemorrhage was not observed after follow-up for 2 to 36 months.Conclusion：The clinical value of interventional therapy for segmental stenosal-occlusive type of BCS is definite;EMS implantation need not be carried out for patients with segmental stenosal-occlusive type of BCS after balloon dilation,EMS implantation must be done in patients with severe stenosis after balloon dilations.
出处
《放射学实践》
北大核心
2011年第12期1301-1303,共3页
Radiologic Practice
