经皮经腔血管成形术治疗布加氏综合征.docVIP

经皮经腔血管成形术治疗布加氏综合征【摘要】 目的 探讨用介入学方法治疗布加氏综合征。方法 先行经皮下腔静脉造影术,明确病变类型。对单纯狭窄型者采用球囊导管扩张术,然后置入血管内支架;对完全膜型或节段闭塞型者,先行穿刺破膜或开通,继而行球囊导管扩张术,节段型者同时置入血管内支架;对伴血栓形成者先行溶栓治疗。结果 本组10例拟诊者,均行下腔静脉造影术,确诊布加氏综合征8例;共行下腔静脉球囊扩张成形术8例,下腔静脉穿刺破膜3例,穿刺开通2例,下腔静脉支架置入术7例,置入9枚支架。未出现下腔静脉破裂、腹腔内出血及肺栓塞等。结论 经皮经腔血管成形术微创、安全、有效,应予推广。 【关键词】 Budd-Chiari综合征;血管成形术;经皮经腔;介入治疗 Treatment of budd-chiari syndrome with percutaneous transluminal angioplasty DONG Sheng-li,ZAN Song-po.Department of gastroenterology,the third peoples hospital,Luoyang ,Henan 471000,China 【Abstract】 Objective To investigate treatment of Budd-Chiari syndrome with interventional method.Methods Types of Budd-Chiari syndrome(BCS) were decided by inferior vena cava(IVC) angiography firstly.Simple stenosis type patients were treat with percutanous balloon dilatation ofIVC,and then with stent placement.Complete membrane and segment block types patients were with reputure of membrane or recanalizing of IVC,and then with percutanous balloon dilatation ofIVC,and segment block type with stent placement as well.Patients accompanied with thrombosis were treated with thrombolysis.Results All 10 patients of the group were examined with IVC angiography,8 patients were confirmed to be BCS.Totally 8 cases of percutanous balloon dilatation ofIVC,3 cases of reputure of membrane ofIVC,2 cases of recanalizing of IVC,and 7 cases of stent placement of IVC were finished,and 9 stents were placed in IVC.There were no IVC rupture,abdominal hemorrhage,pericardial tamponade,pulmonary emblosim,and so on.Conclusion Percutaneous transluminal angioplasty is micro-invasive,safty and effective,and deserved to be popularized. 【Key words】Budd-Chiari Syndrome; Angioplasty; Percutaneous transluminal; Interventional therapy 随着诊断水平的提高,布加氏综合征(Budd-Chiari syndrome,BCS)已成为本地区的临床常见病[1]。经皮经腔血管成形术(percutaneous transluminalangioplasty,PTA) 近年来取得了很大进展,成功率已达90%以上,创伤小、并发症少、恢复快,被推荐为首选治疗方法。我们对10例拟诊BCS患者行下腔静脉造影术、球囊扩张术和穿刺破膜或开通及血管内支架置入术治疗,获得满意疗效。 1 材料 1.1 一般资料 10例患者中,男8例,女2例,年龄16