肝静脉阻塞型布-加综合征介入治疗研究

Interventional treatment of Budd-Chiari syndrome with hepatic stenosis

目的探讨经皮肝穿刺肝静脉再通和成形术在肝静脉阻塞型布-加综合征中应用价值。方法 18例肝静脉阻塞型布-加综合征患者采用经皮肝穿刺肝静脉再通和成形术治疗,随访2a,观察治疗后近、中期疗效。结果治疗成功15例,成功率83.33%;术后6个月患者平均肝静脉压(11.26±3.74)cm H2O明显低于术前(54.11±15.40)cm H2O(P<0.05),门静脉血流量(868±168)mL/min和血容量(14.23±3.26)cm/s明显高于术前(792±189)mL/min和(10.18±3.23)cm/s(P<0.05);术后6个月、1a和2a受干预血管的初始再通分别为14,12和11例。结论经皮肝穿刺肝静脉再通和成形术治疗布-加综合征安全可行,疗效满意。

Objective To discuss the value of percutanous transhepatic recanalization and angionlasty to Budd- Chiari syndrome with hepatic stenosis. Methods Eighteen cases of Budd-Chiari syndrome with hepatic stenosis received percutaneous transhepatic recanalization and angioplasty, and were followed up for two years to observe the middle and short term therapeutic effect. Results Of these 18 cases, 15 cases were successfully cured, with the success rate of 83.33%. The average hepatic vein pressure was （11.26±3.74） cm H20 in 6 months after operation, significantly lower than that before operation （54.11±15.40） cm H2O （P〈0.05）. The portal blood flow and volume were （868±168）mL/ min and （14.23±3.26） cm/s after operation, obviously higher than those before operation （（792±189） mL/min and （10.18±3.23） cm/s ）（P〈0.05）. The initial patency occurred in 14, 12 and 11 cases in 6 months, 1 year and 2 years after operation respectively. Conclusion The method of percutaneous transhepatic recanalization and angioplasty is safe and feasible for Budd Chiari syndrome.