经皮肝穿刺肝静脉造影在肝静脉型Budd-Chiari综合征介入治疗中的应用

Application of PTHV in the Interventional Treatment of BCS with Hepatic Vein Occlusion

目的：探讨经皮肝穿刺肝静脉造影（ＰＴＨＶ）在肝静脉型Ｂｕｄｄ－Ｃｈｉａｒｉ综合征（ＨＶＢＣＳ）介入治疗中的临床应用。材料与方法：对１０例ＨＶＢＣＳ实施ＰＴＨＶ，并采用经皮肝静脉－颈静脉轨迹（轨迹法）或Ｒｕｐｓ－１００肝穿装置行肝静脉开通术（ＰＴＡ和ＥＭＳ置入）。结果：１０例ＨＶＢＣＳ患者皆行ＰＴＨＶ，Ｂ超导向４例，Ｘ线监视６例。介入开通成功９例，失败１例，其中轨迹法开通肝静脉３例，Ｒｕｐｓ－１００装置开通６例。临床效果满意，无严重并发症发生。结论：ＰＴＨＶ能显示ＢＣＳ患者肝静脉开口，明显提高肝静脉开通的成功率。ＰＴＨＶ和开通术结合安全可靠。

Objective: To study the application of percutaneous transhepatic hepatovenography (PTHV) in the interventional treatment of BuddChiari syndrome with hepatic vein occlusion (HVBCS).Materials and Methods:PTHV was performed in 10 cases with HVBCS. Using track between percutaneous transhepatic hepatic vein and transjugular (track method) or Rups100 device (which used TIPSS) recanalized hepatic vein (PTA and EMS placement) on basis of PTHV.Results:The procedure of PTHV was all successful. US guided in 4 cases, Xray guided in 6 cases. 9 patients were successfully performed recanalization of occlusion with hepatic vien. One case was failure. 3 of them were treated by track method, the others were treated using Rups100 device. Symptoms of abdominal distention and liver enlargement disapeared after operation. No serious complications. Conclusion: PTHV can demonstrate the opening of hepatic vein, the situation of hepatic vein blood flow and also increase recanalization rate in the interventional treatment of HVBCS. Therefore, it should be a safe and effective method in the treatment of HVBCS when combined with PTHV PTA and EMS placement.