副肝静脉成形术在节段性肝静脉梗阻型布加综合征介入治疗中的应用

发布时间：2018-03-25 04:07

本文选题：布加综合征　切入点：肝静脉　出处：《临床放射学杂志》2015年08期

【摘要】：目的探讨副肝静脉成形术在节段性肝静脉梗阻型布加综合征(BCS)治疗中的应用价值。方法 30例节段性肝静脉梗阻型BCS患者行副肝静脉球囊扩张术,其中3例予以支架置入治疗。术后统计并分析技术成功率,症状缓解情况及随访的相关数据。结果所有患者均治疗成功,未出现严重相关并发症。术中共检出30支代偿性增粗的副肝静脉,主干直径6~11 mm,平均(8.43±1.43)mm,副肝静脉与肝静脉之间均存在数量不等的交通支。副肝静脉压力由术前的平均(46.63±5.44)cmH 2O降至术后的(28.00±3.54)cmH 2O,差异有统计学意义(t=19.897,P0.01)。经随访,25例患者症状消失或减轻;5例患者症状复发,其中4例再次接受副肝静脉球囊扩张术,1例行经颈静脉肝内门腔分流术。结论对于节段性肝静脉梗阻型BCS的患者,若患者副肝静脉代偿性扩张,开通副肝静脉同样可取得满意的治疗效果。
[Abstract]:Objective to investigate the angioplasty in segmental hepatic vein obstruction in Budd Chiari syndrome with accessory hepatic vein (BCS) application value in the treatment. Methods 30 cases of segmental obstruction of the hepatic vein type BCS patients with accessory hepatic vein angioplasty and stenting in the treatment to 3 cases. Statistics and analysis of postoperative technology success rate. The related data of symptoms and follow-up. Results all patients were treated successfully without serious complications. Patients were detected in the 30 compensatory thickening of the accessory hepatic vein, trunk diameter of 6~11 mm, the average (8.43 + 1.43) mm, between the accessory hepatic vein and hepatic veins are a number of traffic. Accessory hepatic vein pressure by the average preoperative (46.63 + 5.44) 2O to cmH after operation (28 + 3.54) cmH 2O, the difference was statistically significant (t=19.897, P0.01). During follow-up, 25 patients symptoms disappeared or alleviated; 5 cases of patients with recurrence of symptoms, including 4 cases of liver again to accept the vice Intravenous balloon dilatation and transjugular intrahepatic portosystemic shunt in 1 patients. Conclusion for patients with segmental hepatic vein obstruction type BCS, if the accessory hepatic veins are compensated for expansion, a satisfactory result can also be achieved by opening the accessory hepatic veins.

【作者单位】：徐州医学院附属医院介入放射科;
【基金】：江苏省医学创新团队:布-加综合征的基础及介入治疗研究(编号:LJ201143) 江苏省临床医学科技专项:布加综合征介入诊疗规范化研究(编号:BL2012021) 江苏省徐州医学院“振兴计划”项目(编号:XZMC20122015)
【分类号】：R575

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