下腔静脉超长段闭塞性Budd-Chiari综合征的介入治疗

Budd-Chiari syndrome with over-long segmental obstruction:interventional treatment

目的 :探讨采用介入技术治疗下腔静脉超长段闭塞性Budd Chiari综合征的临床疗效及安全性。方法 :选取术前经下腔静脉造影检查 ,病变闭塞段长度超过 5cm的患者 30例。对下腔静脉闭塞段应用Rups 10 0穿刺系统穿刺成功后行PTA及支架置入术。结果 :2 9例治疗成功 ( 96 % ) ,腹水缓解 ( 96 .5 % ) ,术前、后闭塞两端的压差降为 5～ 12cm水柱 ,平均下降 8.4cm水柱。结论 :下腔静脉超长段闭塞的病理基础为下腔静脉多膜闭塞 ,介入治疗成功率为 96 %。与单膜性或节段性闭塞的介入治疗成功率相一致。临床效果确切 ,安全可靠 。

Objective:To investigate the clinical effect and safety for the interventional treatment of Budd Chiari syndrome (BCS) with over long segmental obstruction.Methods:Thirty cases with long segmental obstruction(>5.0cm) were chosen,which had been diagnosed by inferior vena cava angiography.PTAs were performed and stents were implanted after the long segmental obstruction had been pierced successfully with Rups 100 puncture system.Results:The interventional management in twenty nine cases (96%) were performed successfully,ascites alleviation (96.5%). The pressure of IVC fell to 5～12cm H 2O,falling by 8.4cm H 2O on average.Conclusion:The pathological basis of over long segmental obstruction in SVC is multi membrane. The interventional treatment has a high success rate (96%) in curing the long segmental obstruction, consistent with the success rate of interventional management in single membrane or segmental obstruetion.This method is very effective and safe.It should be the first choice for clinical treatment.