介入治疗下腔静脉型布加综合征18例临床分析

Clinical analysis of 18 cases of Budd-Chiari syndrome due to inferior vena cava obstruction treated by interventional therapy

目的评价下腔静脉型布加综合征（BCS）介入治疗效果。方法回顾性分析2010年1月至2016年1月于海南省人民医院血管外科接受介入治疗的18例下腔静脉型BCS患者的临床资料。结果 18例患者手术方式均采用介入引导、上下腔静脉会师造影并球囊扩张术,18例患者均成功开通,其中10例半年内行2次手术,8例行3次手术,逐步扩大球囊直径,术前术后下腔静脉测压提示下腔静脉内压力显著降低[术前（30±10）cm H2O,术后（15±7）cm H2O],症状完全消失。18例患者均未植入支架,术后所有患者症状均得到明显改善。随访1248个月,无死亡,无一例复发及严重并发症。结论介入治疗下腔静脉型布加综合征安全有效,并发症发生率低,疗效满意。

Objective To evaluate the effcacy of interventional therapy in Budd-Chiari syndrome(BCS) due to inferior vena cava(IVC) obstruction. Methods The clinical data of 18 patients with BCS due to IVC obstruction who received interventional therapy in Department of Vascular Surgery in People's Hospital of Hainan Province from January 2010 to January 2016 were retrospectively analyzed. Results All the 18 patients were treated by interventional therapy,combined with superior/inferior vena cava two-way angiography and balloon dilatation. Recanalization was successful in all the pateitns, and all patients underwent repeat dilatation with increasing balloon diameter, with 10 patients undergoing two operations and 8 patients undergoing three operations during half a year. Inferior vena cava pressure was decreased significantly before and after operation [preoperative(30 ± 10) cm H_2O, postoperative(15 ± 7) cm H_2O]. No stent was inserted in all the patients, and the clinical symptoms were significantly improved after treatment. During the followed-up of 12~48 months, no death, recurrence or severe postoperative complications were found. Conclusion Interventional therapy is a safe and effective treatment for BCS due to IVC obstruction, with low incidence of complications and satisfactory results.