改良内支架治疗布加氏综合征的临床应用(附33例报告)

CLINICAL APPLICATION OF MODIFIED Z-STENT IN BUDD- CHIARI SYNDROME (REPORT OF 33 CASES)

目的 :探讨改良内支架治疗布加综合征的方法。方法 :对 33例下腔静脉膜型及狭窄型布加氏综合征经皮经腔球囊导管扩张成形改良内支架置入术。其中肝后段下腔静脉膜型阻塞 2 4例 (完全阻塞者 19例 ,膜孔者5例 ) ;下腔静脉狭窄者 9例 ,狭窄长度 1.9cm～ 11.6cm。结果 :治疗前下腔静脉压力平均 2 7.33± 4 .12cmH2 O ,上腔静脉平均压力 4 .0 8± 1.5 1cmH2 O ;球囊扩张后下腔静脉压力下降至平均 18.6 7± 5 .0 7cmH2 O ,上腔静脉压力上升至平均 7.0 8± 2 .2 7cmH2 O ;支架置入后下腔静脉压力下降至平均 11.4 2 4± 2 .11cmH2 O ,上腔静脉压力上升至平均 8.83± 2 .6 2cmH2 O。随访 3～ 4 4个月 ,体征全部消失 2 2例 ,3例术后一度出现黄疸 ,经对症治疗后好转。结论 :改良内支架有效地预防了因支架放置引起的肝静脉再次阻塞。

Objective:To explore the treatment for Budd-Chiari Syndrome using modified z-stent.Methods:We treated 33 cases of membranous or narrow Budd-Chiari Syndrome(BCS) by PTA and modified z-stent placement. Twenty-four cases were the type of membranous obstructive( including 19 eases absolute block and 5 cases partly), and 9 cases were narrow with the average length of 1.9～11.6cm. Results: The inferior vena cave(IVC) pressure declined from 27.33 ±4.12cmH 2O to 11.42 ±2.11cmH 2O, and the superior vena cave(SVC) raised from 4.08±1.51cmH 2O to 8.83±2.62cmH 2O.Followed-up of 3 to 44 months, 22 cases had no physical signs, and 3 cases had ever jaundice of whom got better with therapy. Conclusion:Modified z-stent placement can be effectively used to prevent liver vene from re-blocking for trestle placement.