论文部分内容阅读
目的 探讨Ｂｕｄｄ—Ｃｈｉａｒｉ综合征血栓形成性下腔静脉闭塞的介入治疗方法。材料和方法 １０例下腔静脉血栓性闭塞患者，病变长度２～１３ｃｍ，介入治疗前给予１～２周以上抗凝，溶栓治疗。下腔静脉再通采用Ｒｕｐｓ—１００型肝内穿刺针的金属鞘及其保护套管，再通后行球囊导管扩张并植入内支架。结果 １０例患者行下腔静脉再通、扩张和支架植入获得成功。患者平均下腔静脉压由术前的３．４２±０．６６ｋＰａ降至术后的１．９０±０．４１ｋＰａ。术中和术后无肺动脉栓塞和其他并发症发生。术后患者症状和体征于２周后明显改善或消失。随访３～２８个月显示经开通的下腔静脉均保持通畅，无再狭窄及血栓形成发生。结论 下腔静脉介入治疗前１～２周给予良好的抗凝治疗．是预防术中血栓脱落致肺梗塞的最佳措施。自膨胀式内支架有支撑和固定血栓的作用，植入时应覆盖闭塞段全程。
Objective To investigate the interventional treatment of thrombus-induced inferior vena cava occlusion in Budd-Chiari syndrome. Materials and Methods 10 cases of inferior vena cava thrombosis occlusion patients, the length of 2 ~ 13cm, before interventional therapy for 1 to 2 weeks or more anticoagulant and thrombolytic therapy. The inferior vena cava was recanalized with a metal sheath of Rups-100 intrahepatic puncture needle and its protective cannula. The balloon catheter was dilated and implanted into the stent. Results In 10 patients, inferior vena cava recanalization, dilation and stent implantation were successful. Mean intimal pressure decreased from 3.42 ± 0.66 kPa preoperatively to 1.90 ± 0.41 kPa postoperatively. No intraoperative and postoperative pulmonary embolism and other complications occurred. Postoperative symptoms and signs of patients significantly improved or disappeared after 2 weeks. Follow-up of 3 to 28 months showed that the opened inferior vena cava remained open without restenosis and thrombosis. Conclusions Good anticoagulant therapy is given 1 to 2 weeks before interventional therapy in inferior vena cava. Is to prevent intraoperative thrombus shedding caused by the best way to pulmonary infarction. Self-expanding stent has the support and the role of thrombosis, implants should cover the entire occlusion section.