球囊扩张血管成形治疗布－加综合征

Treatment of Budd-Chiari syndrome by percutaneous transluminal angioplasty

采用球囊扩张下腔静脉成形术治疗布－加综合征４０例。４０例中男１８例，女２２例。病程１～２４年。病理类型为膜性下腔静脉阻塞（３７例）和短节段性下腔静脉阻塞（３例）。本组病例总扩张成功率为９２．５％（３７／４０）。１例因肺梗塞而死亡；５例下腔静脉侧壁被穿刺导丝刺穿，后者均经非手术治疗痊愈。随访３至３８个月，２例症状复发并再次接受手术治疗。作者指出，球囊导管扩张下腔静脉成形适应于布－加综合征的某些病理类型，如膜性下腔静脉阻塞和短节段性下腔静脉阻塞，可取得满意的效果。若Ｂ超或／和下腔静脉造影显示下腔静脉内有血栓者，则为球囊扩张成形术的绝对禁忌证。

Abstract Forty patients with Budd-Chiari syndrome (B-CS)were treated by percutaneous transluminal angioplasty (PTA) using balloon catheter dilatation technic. There were 18 males and 22 females with history from 1 to 24years. The pathomorphological types were of membraneous obstruction (37) and short segmental obstruction (3) of inferior vena cava. In this group,the total success rate was 92. 5% (37/40). One patient died of pulmonary infarction. The caval veins were perforated by the guide wire in 5 cases,but all of them were cured without any operation. 3 ～ 38 months follow-up revealed,2 recurrence necessitating further surgery. The authors indicated that the indication of PTA is indicated for some types of B-CS, such as membranous and short segmental obstruction (< 3cm) of inferior vena cava. Thrombus detected by B-US or/and caval venography is controindication for PTA.