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目的 对31例下腔静脉膜型及狭窄型布加综合征经皮穿刺球囊导管扩张成形金属支架植入术。方法 其中肝段下腔静脉模型阻塞17例(有孔者7例,完全闭塞10例;3支主肝静脉通畅者5例,2支通畅者8例,1支通畅者4例);下腔静脉狭窄者14例,狭窄长度3～10cm,无1例显示肝静脉。结果 治疗前下腔静脉压29.38±3.37cmH2O,治疗后平均下降14.69±3.10cmH2O;1例导管刺破下腔静脉进入心包,造成心包填塞,虽经手术但死于感染;另2例手术后21d和35d死于食道静脉破裂出血;其余28例均获成功,随访3～48个月,平均295个月,全部体征消失22例,6例仍有轻度肝脾肿大。结论 讨论了该法的适应证,技术操作对效果的影响及术后处理。
Objective To investigate the clinical effects of percutaneous transluminal balloon catheterization and stent implantation in 31 cases of inferior vena cava membranous and stenosis-type Budd-Chiari syndrome. Methods Among them, hepatic segment inferior vena cava model obstruction in 17 cases (7 cases with perforation, complete occlusion in 10 cases; 3 cases of the main hepatic veins in 5 cases, 2 cases in 2 cases, 1 case in 4 cases); lower chamber 14 cases of venous stenosis, stenosis length of 3 ~ 10cm, no case of hepatic vein. Results Before treatment, the IVC pressure was 29.38 ± 3.37cmH2O, with an average decrease of 14.69 ± 3.10cmH2O after treatment. One catheter punctured the inferior vena cava and entered the pericardium, resulting in pericardial tamponade, but died of infection after surgery. The other two cases were 21 days after operation And 35 days died of esophageal variceal hemorrhage. The other 28 cases were successfully followed up for 3 ~ 48 months (average 295 months), all the signs disappeared in 22 cases and 6 cases still had mild hepatosplenomegaly. Conclusion The discussion of the indications of the law, the impact of technical operations on the effect and postoperative management.