血管内支架在肿瘤所致下腔静脉梗阻中的应用

Self-expandable metallic stent therapy for malignant inferior vena cava obstruction

目的 探讨恶性肿瘤所至下腔静脉梗阻植入金属支架治疗的临床价值。方法 18例患者中，原发性肝癌6例，肝转移癌3例，胃癌2例，腹膜后肿物2例，肾癌3例，淋巴瘤1例，胰腺癌1例。均造成下腔静脉的完全或部分梗阻，梗阻段长度30～90mm直径0～5mm，采用经皮股静脉穿刺植入金属支架治疗。结果 18例患者均一次手术成功，患者梗阻症状积分由4～5分降至术后0～2分两者差异显著。结论 金属膨式支架可迅速缓解下腔静脉恶性梗阻患者的临床症状是有效的姑息性治疗手段，值得推广。

Objective To evaluate the effectiveness of the metallic Z-type self-expandable stent in treating the patients with malignant obstruction of inferior vena cava （IVC）. Methods Eighteen patients, including 6 cases of primary hepatic carcinoma, 3 cases of metastases of liver, 3 cases of renal cell carcinoma, 2 cases of cancer of the stomach, 2 cases of peritoneal behind tumor, 1 case of lymphoma, 1 case of pancreatic cancer. Completely or partial occlusion of IVC were noted. Stents were introduced via femoral vein. Results All cases were successfully treated. Symptoms of obstruction were significantly improved by showing a decline of score of obstruction. Conclusion The metallic Z stent is a effective in relieving symptoms caused by malignant obstruction of IVC.