PTA与EMS治疗Budd－Chiari综合征的临床评价（附32例报告）

Clinical Evaluation of Budd-Chiari Syndrme Treated with PTA and EMS

本文报道了应用球囊导管成形术（ＰＴＡ）和血管内支架（ＥＭＳ）置入术治疗Ｂｕｄｄ－Ｃｈｉａｒｉ综合征（ＢＣＳ）的临床观察结果。３２例中，膜性病变２４例，节段性病变８例。其中，ＰＴＡ组２１例，术后除１例死于ＤＩＣ外，其余２０例已平均随访４２．２个月（３８～６８个月），有１０例（５０％）发生再狭窄再闭塞。ＥＭＳ组１７例，已平均随访２４．３个月（２０～３６个月），仅有２例（１２％）出现下腔静脉再狭窄。但经再次ＰＴＡ与ＥＭＳ治疗后均得到良好再通。本组结果表明：ＰＴＡ治疗ＢＣＳ不仅近期疗效显著，而且可使半数左右的病人获得满意的长期开通效果。而对ＰＴＡ效果不满意或再狭窄再闭塞者可采用ＥＭＳ治疗。这样可明显提高ＢＣＳ介入治疗的临床效果。

patients with Budd-Chiari syndrome(BCS)were treated with percutaneous transluminal angioplasty(PTA) or / and expandable metallic stent(EMS) placement. Among those patients membranous lesion was found in 24 and segmental lesion in 8. In PTA group 21 patients, except one died after the procedure, good to excellent results were obtained in 20, and restenosis/ reobstruction was depicted in 10 patients(50%) in 38～68 months(average 52.2) on follow up study, In EMS group of 17 patients, restenosis was depicted in 2 patients(12%) in 20～36 months(average 24.3) on follow up study. PTA in treating patients with BCS not only with good to excellent short term results and the long term results is also relativly good. As for those patients on whom satisfactory patency can not be obtained. or restenosis/ reobstruction after PTA, EMS placement should be perfonned and better results may be obtained.