原发性Budd-Chiari综合征的介入治疗

The intervention therapy on primary Budd-Chiari syndrome

目的分析经皮球囊扩张治疗原发性Ｂｕｄｄ－Ｃｈｉａｒｉ综合征下腹静脉闭塞病变的疗效。方法采用Ｓｅｌｄｉｎｇｅｒ穿刺血管方法，行下腔静脉及右心房造影，确定下腔静脉闭塞段，用Ｂｒｏｃｋｅｎｂｒｏｕｇｈ穿刺针开通闭塞段，球囊导管扩张病变治疗下腔静脉闭塞病变４２例。结果成功率为１００％，病变区血管直径扩至１２～２１ｍｍ，平均（１８±１３．１）ｍｍ，下腔静脉压自（１７±３）ｍｍ Ｈｇ，降至（７．５±１．８）ｍｍ Ｈｇ，疗效显著（Ｐ＜０．０１），症状体征明显减轻或消失。结论临床观察表明，Ｂｒｏｃｋｅｎｂｒｏｕｇｈ穿刺针开通病变血管是安全的，球囊扩张对绝大部分原发性Ｂｕｄｄ－Ｃｈｉａｒｉ综合征下腔静脉闭塞病变的疗效满意。

Objective The effects of the intervention therapy on inferior vena vava (IVC) occlusion in primary Budd-Chiari syndrome (BCS) were studied. Methods 42 patients with BCS were treated with balloon angioplasty and segmental obstruction was opened with Brockenbrough needle. Results The successful rate of this operation was 100%. The diameter of IVC was increased to 12-21mm, the average diameter of IVC to 18±3.1 mm (x ± s). The pressure of IVC decreased from 17±3 mm Hg to7.5±1.8 mm Hg (u=2.71, P<0.01). The symptoms and signs were alleviated or subsided. Conclusion The intervention therapy on IVC occlusion lesion in primary BCS with balloon angioplasty and opening of segmental obstruction with Brockenbrough needle is effective and safe.