布加综合征:搅拌溶栓治疗下腔静脉内新鲜血栓形成

Agitating thrombolysis technique for the treatment of inferior vena cava fresh thrombus in patients with Budd-Chiari syndrome

目的探讨搅拌溶栓技术在布加综合征合并下腔静脉内新鲜血栓形成的临床应用。方法收集2004年8月-2009年3月布加综合征合并下腔静脉内新鲜血栓形成5例,首先经股静脉途径行下腔静脉造影,而后开通下腔静脉,再采用搅拌溶栓技术溶解血栓,直至血栓完全消失,最后行腔内球囊扩张血管成形术。术后采用多普勒超声随访下腔静脉通畅情况。结果5例布加综合征合并下腔静脉内新鲜血栓形成患者均为下腔静脉膜性阻塞,采用搅拌溶栓后血栓均完全消失,球囊扩张血管成形术后均未出现肺栓塞症状。术后随访下腔静脉血流通畅,无血栓再次形成,无一例下腔静脉再阻塞。结论搅拌溶栓技术可用于治疗布加综合征合并下腔静脉内新鲜血栓,能一次性完成整体治疗,安全有效。

Objective To evaluate the therapeutic efficacy of agitating thrombolysis technique for Budd-Chiari syndrome complicated with inferior vena cava（IVC） fresh thrombus.Methods From August 2004 to March 2009, 5 patients of Budd-Chiari syndrome（four males and one female, aged 36-48 years） with IVC fresh thrombus were treated with agitating thrombolysis technique.After angiography of IVC the recanalization of IVC was performed, which was followed by agitating thrombolytic therapy.Finally, IVC was dilated with percutaneous transluminal balloon angioplasty.Clinical follow-up of IVC patency was conducted by color Doppler sonography.Results After agitating thrombolysis, the thrombi were completely disappeared in all 5 patients without single occurrence of pulmonary embolism.In all patients, IVC remained patency on color Doppler ultrasonograph after following up for a mean period of 23.8 months.Conclusion Agitating thrombolysis technique is a safe and effective treatment for Budd-Chiari syndrome complicated with IVC fresh thrombus.