腔内血管技术在肝静脉回流障碍综合征治疗中的应用

Application of endovascular technique in the treatment of Budd-Chiari syndrome

目的 :探索一种简单、安全、有效的治疗肝静脉回流障碍 (Budd- Chiari)综合征的新方法。 方法 :在 11例肝静脉回流障碍综合征患者中 ,应用经皮穿刺下腔静脉气囊扩张成形术治疗获得成功后 ,有 9例患者同时置入血管内支架。 3例肝静脉完全闭塞者在下腔静脉腔内治疗术成功后 1周内行肠系膜上静脉 -下腔静脉间人造血管“H”型分流术。结果 :11例患者中 ,除 1例在腔内治疗术后出现轻度心功能不全表现外 ,无手术并发症 ,术后随访 6～ 35个月 ,血管内支架通畅、无移位 ,分流血管无血栓栓塞 ,门脉高压症状明显缓解 ,患者生活质量提高。 结论

Objective:To develop a simple, safe and effective method to treat Budd Chiari syndrome. Methods:In 11 cases of Budd Chiari syndrome, percutaneous transluminal balloon dilatation of inferior vena cava had been successfully done first. Endovascular stents were placed simultaneously in the dilated segments in 9 cases. After the endovascular intervention, “H” mode shunts of vessel prosthesis between superior mesenteric vein and inferior vena cava were performed in 3 cases one week later. Results: No other complications occurred in operative process except mild heart dysfunction in 1 case. Patients were followed up for 6 to 35 months postoperatively. There was no re obstruction within inferior vena cava, no stent dislocation or thrombio embolization in shunts. Clinical manifestations of portal and systemic hypertension were released significantly. The life quality in most patients was improved. Conclusion: Endovascular technique is the first choice for the treatment of Budd Chiari syndrome, except that the distance of obstruction in inferior vena cava is longer than 5 cm.