吸、溶栓术联合血管腔内成形术在布-加综合征合并下腔静脉血栓形成治疗中的应用

The application of thrombus aspirate technique and thrombolysis in Budd-Chiari syndrome complicated with inferior vena cava thrombus

目的:探讨吸、溶栓术联合血管腔内成形术治疗布-加综合征(Budd-Chiari syndrome,BCS)合并下腔静脉(IVC)血栓形成中的效果。方法:对11例BCS合并IVC血栓形成患者经股静脉穿刺行IVC造影,采用吸栓加溶栓技术消除血栓,后行腔内球囊扩张血管成形术。出院后采用彩色多普勒随访IVC有无再狭窄或闭塞。结果:11例均为IVC膜性阻塞,采用吸栓加溶栓后血栓完全消失7例;保留IVC导管溶栓4 d后血栓消失2例;7 d后消失2例;腔内球囊扩张血管成形术后均未出现肺栓塞症状。术后随访IVC通畅良好,无IVC再阻塞及血栓形成发生。结论:吸栓加溶栓术联合血管腔内成形术治疗BCS合并IVC血栓形成的效果良好。

Objective： To evaluate the therapeutic efficacy of thrombus aspiration technique and thrombolysis of intracavitary and percutaneous transluminal angioplasty （PTA） for Budd-Chiari syndrome （BCS） complicated with inferior vena cava （ IVC ） thrombus. Methods：The clinical data of 11 cases of BCS complicated with IVC thrombus were collected. Venipuncture through femoral vein and inferior vena cavography were performed, and aspiration thrombus technique and thrombolysis of intracavitary were used to eliminate thrombus. After angiography of IVC, the recanalization of IVC was performed, which was followed by thrombus aspiration technique and thrombolysis of intracavitary. Finally, IVC was dilated with percutaneous transluminal balloon angioplasty. The clinical observation was used by color Doppler post-discharge. Results： All the patients＇ occlusion was barrier diaphragm before operation, adopting this treatment,7 patient＇s thrombus was eliminated instantly, after using intraductal thrombolysis,2 patients＇ thrombus was eliminated 4 days later,2 patients＇ thrombus was eliminated 7 days later. And pulmonary embolism was not happened with percutaneous transluminal balloon angioplasty. In following-up visit, blood current of IVC was continuous, there had no re-occlusion or thrombus happening. Conclusions ：The therapeutic efficacy of thrombus aspiration technique and thrombolysis of intracavitary and PTA for BCS complicated with IVC thrombus is safe and effective.