| 李天晓,李选,谢敬霞.经皮肝穿刺肝静脉成形术治疗肝静脉阻塞型Budd-Chiari综合征的临床研究[J].中国医学影像技术,2007,23(6):901~904 |
| 经皮肝穿刺肝静脉成形术治疗肝静脉阻塞型Budd-Chiari综合征的临床研究 |
| Clinical study on percutaneous transhepatic angioplasty of hepatic veins in treatment of Budd-Chiari syndrome with occlusion of hepatic veins |
| 投稿时间：2007-01-26 修订日期：2007-06-09 |
| DOI： |
| 中文关键词: Budd-Chiari综合征 肝静脉阻塞 腔内血管成形 支架 |
| 英文关键词:Budd-Chiari syndrome Occlusion of hepatic vein Transluminal angioplasty Stent |
| 基金项目: |
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| 摘要点击次数: 2063 |
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| 中文摘要: |
| 目的 探讨经皮肝穿刺入路肝静脉腔内成形治疗肝静脉型Budd-Chiari综合征(BCS)的可行性和中远期疗效。方法 1996年9月-2006年10月收治单纯肝静脉阻塞型及肝静脉阻塞伴有下腔静脉阻塞型B-CS患者101例,男52例,女49例;平均年龄31.3岁(15~57岁)。透视下首先行经皮肝穿刺入路肝静脉造影,明确阻塞部位、程度及侧枝循环形成情况,再行阻塞段开通及球囊扩张或支架成形术治疗。结果 肝右静脉球囊扩张66例,支架植入2例;肝左静脉球囊扩张11例;副肝静脉球囊扩张13例,技术成功率91%(92/101)。随访74例,术后 6个月、1年和2年的受干预血管的初始再通率分别为83.78%(62/74)、78.38%(58/74)和76.47%(39/51),其辅助再通率分别为94.59%(70/74)、91.89%(68/74)和84.31%(43/51)。围手术期急性肝静脉血栓形成3例,肝穿刺道出血2例,肝包膜下血肿1例,肺栓塞1例,均经保守治疗痊愈,无致死性并发症发生。结论 采用经皮肝穿刺入路肝静脉腔内成形技术治疗膜性或节段性肝静脉型BCS技术简单、安全、有效,其中远期效果令人满意。 |
| 英文摘要: |
| Objective To evaluate the feasibility and long-term efficacy of percutanteous transhepatic recanalization and angioplasty of hepatic veins in the treatment of Budd-Chiari syndrome with occlusion of hepatic viens. Methods From September 1996 to October 2006, 101 patients with Budd-Chiari syndrome were recruited occlusion of hepatic veins or accompanied by occlusion of inferior vena cava for the clinical study, including 52 males and 49 females (average age 31.3 years). Initiately, percutaneous transhepatic hepatovenography was performed to identify the localization of occlusion, severity and collateral circulation, recanalization of occluded hepatic veins and balloon dilatation or stent placement was then utilized to treat the disease. Results Sixty-six patients were treated with balloon dilation of right hepatic vein and 2 cases accompanied stent placement, and 11 cases with balloon dilation of left hepatic veins, 13 cases with balloon dilation in accessory hepatic vein. The success ratio was 91% (92/101). In follow-up of 74 cases, the ratios of initial success of recanalization of hepatic veins were 83.78% (62/74), 78.38% (58/74) and 76.47% (39/51) at 6 months, 1 and 2 years after operation respectively, while the ratios of assistant recanalization were 94.59% (70/74), 91.89% (68/74) and 84.31% (43/51) at 6 months, 1 and 2 years after operation, respectively. During perioperative procedure, 3 cases were observed to have acute hepatic vein thrombosis, 2 cases with liver puncture tract bleeding, 1 case with subcapsular hematoma, and 1 case with pulmonary embolism, no death was seen after systemic treatment. Conclusion Percutaneous transhepatic transluminal angioplasty is safe and effective to treat Budd-Chiari syndrome with membraneous and segmental lesions. The long-term efficacy is warranted. |
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