经皮肝静脉开通术治疗布加氏综合征

Percutaneous hepatie vein canalization for Budd-Chiari syndrome caused by occlusion of hepatic vein

目的 探讨布加氏综合征中肝静脉阻塞的简便有效的介入治疗方法。方法肝静脉型和混合型布加氏综合征 12例 ,在DSA引导下进行肝静脉穿刺、球囊扩张及内支架置入 ,使阻塞的肝静脉再通。经颈静脉途径治疗 7例 ,经皮经肝穿刺途径治疗 5例。结果术后 12例患者原阻塞的肝静脉内径平均达 1 1cm ,血流恢复正常 ,平均肝静脉压由 3 6 2kPa降至 1 2 8kPa(P <0 .0 1)。短期内病人的临床症状缓解。随访 7～ 32个月 ,2例于 5～ 13个月时症状复发 ,经对症治疗或球囊扩张后缓解。术中术后无严重并发症发生。结论合理的介入治疗途径对布加氏综合征的介入治疗有着非常重要的临床意义。

Objective To study a effective,simple and convenient method for hepatic vein occlusion in Budd-Chiari syndrome.Method Digital subtraction angiography guided percutaneous hepatic vein puncture.balloon dilation and stent placement were performed in 12 patients with Budd-Chiari syndrome caused by occlusion of hepatic vein.The hepatic veins blocked were unobstructed.Results After the procedure,the mean diameter of hepatic vein was 1.1cm,the centripetal blood flow of hepatic vein was restored.the mean hepatic vein pressure dropped from 3.62kPa to 1.28kPa(P<0.01).The symptoms and signs of hepatic vein occlusion disappeared or markedly improved in all patients.The disease recurred during the 5～13months' follow-up,the disease was improved by allopathy or balloon dilation.Conclusion Resonable interventional theraputic approach was very important to Budd-Chiari syndrome caused by occlusion of hepatic vein.