Budd-Chiari综合征介入诊疗的各种术式及其特点

Interventional approaches of diagnosis and treatment of Budd-Chiari syndrome

目的探讨Budd—Chiari综合征的介入诊断与治疗的各种手术方式及其特点。方法回顾2004年8月～2011年6月52例Budd—Chiari综合征患者，其中肝静脉阻塞型17例，下腔静脉阻塞型24例，混合型11例。所有病例均采用seldinger技术右股静脉入路行下腔静脉造影，必要时经皮肝穿肝静脉人路、颈静脉入路造影或成形术。破膜针选用泥鳅导丝或球囊保护钢针。结果52例各型Budd—Chiari综合征患者手术成功50例。随访30例手术成功患者6～18个月，有4例复发，其中有2例为未能坚持双抗治疗。结论90％以上的Budd—Chiari综合征介入治疗成功，一定程度上取代了外科治疗。熟练掌握介入治疗的各种手术方式及其特点，可以优化手术方案，提高手术安全性，保证手术质量。

Objective To evaluate various interventional approaches of diagnosis and treatment of Budd-Chiari syndrome. Methods 52 patients underwent interventional treatment for BCS from 8/2004 to 6/201t including occlusion of hepatic veins （17）, IVC （24）, or both hepatic veins and IVC （11）. Inferior vena cavography was performed by puncturing the fight femoral vein using Seldinger＇ s technique on all patients. When necessary, angioplasty was performed using the percutaneous hepatic vein or jugular vein approaches. Results Of 52 patients, 50 were successfully treated. Symptoms recurred in 4 patients during the 6-18 month follow- up, of whom 2 did not comply with antiplatelet therapy. Conclusions More than 90% of patients with BCS can be successfully treated by various interventional methods.