摘要
目的探讨不同类型Budd-Chiari氏综合征(BCS)的介入治疗方法及其临床价值。方法对89例Budd-Chiari综合征患者分别采用下腔静脉球囊扩张术(PBD)、下腔静脉球囊扩张和血管内支架(stent)放置术、经颈静脉行肝静脉成形术或肝内门腔静脉分流术(TIPSS)、经皮经肝和经颈静脉行肝静脉成形术及下腔静脉和肝静脉双球囊扩张术、下腔静脉和肝静脉双支架放置术。结果治疗成功率为96%,术中无一例死亡及肺栓塞等严重并发症发生。结论1.Ⅰa、Ⅱ及Ⅲ型只需行PTA治疗,Ⅰb型采用TIPPS治疗,而Ⅳ型要PTA加stent治疗;2.Ⅲ、Ⅳ型病例行血管成形术前充分溶栓是必要的。3.B超引导下经皮肝静脉穿刺可提高穿刺成功率、减少并发症。
Objective Pcreutanous balloon dilatation （PBD） and stenting for variou stypes of Budd - Chiari syndrome （BCS） were investigated arid evaluated. Methods 89 patients with BCS were diagnosed and treated in 7 years. The interventional procedures included： PBD for inferior vena cava （IVC）, PBD and stent placement for IVC, hepatic vein angioplasty via transjngular vein, hcpatie vein angioplasty via transhepatic and transjugula approaeh or transjugular intrahepatic portosystemic stent shunt（TIPSS）, accessory hepatic vein angioplasty, pereutanous dual balloon dilatation for IVC and hepatic vein, and percutanous dual stent plaeenlent for IVC and hepatic vein. Results The successful rate of PBD and stent placement was 96% arid themortality was 0% in this series. Conclusion PBD was reliable procedures in treating type Ⅰa、Ⅱ and Ⅲ BCS, and TIPPS is used for type Ⅰ b BCS, But PBD and stenting is nessory for patients with type Ⅳ BCS. Throndolysis was nessory for paitients with type Ⅲ,Ⅳ BCS. Under the guide of Color Doppler Ultrasound can improve the success of peleutanous hepatic vein and reduce themortality.
