CAJ | 학술논문

目的探讨改良式Z-stent在布-加综合征(BCS)介入治疗中的应用价值.方法回顾性分析二家医院的12例BCS.全组病例在手术前均作彩色Doppler检查,确定病变部位和性质,选择支架类型.术中在DSA监视下作腔静脉造影,破膜、扩张.然后正确置入带有标记的改良式支架,将缺口部分的一侧对准肝静脉开口处,再作腔静脉造影和(或)肝静脉造影,确定支架放置部位是否正确.本组12例下腔静脉膜性阻塞或节段性阻塞,全部使用改良式支架.结果破膜扩张后下腔静脉压由27.33±4 12cmH2O降至18 67±5 07cmH2O(P＜0.01),放置支架后下腔静脉压由18 67±5.07cmH2O降至11.42±2.11cmH2O(P＜0.01).随访2.5年肝静脉和下腔静脉均无血栓形成,说明改良支架可预防压迫肝静脉开口和防止下腔静脉狭窄部的回缩.结论改良式Z-stent腔内支架预防血栓形成是一种安全有效的方法,远期效果尚待进一步观察.
목적탐토개량식Z-stent재포-가종합정(BCS)개입치료중적응용개치.방법회고성분석이가의원적12례BCS.전조병례재수술전균작채색Doppler검사,학정병변부위화성질,선택지가류형.술중재DSA감시하작강정맥조영,파막、확장.연후정학치입대유표기적개량식지가,장결구부분적일측대준간정맥개구처,재작강정맥조영화(혹)간정맥조영,학정지가방치부위시부정학.본조12례하강정맥막성조새혹절단성조새,전부사용개량식지가.결과파막확장후하강정맥압유27.33±4 12cmH2O강지18 67±5 07cmH2O(P＜0.01),방치지가후하강정맥압유18 67±5.07cmH2O강지11.42±2.11cmH2O(P＜0.01).수방2.5년간정맥화하강정맥균무혈전형성,설명개량지가가예방압박간정맥개구화방지하강정맥협착부적회축.결론개량식Z-stent강내지가예방혈전형성시일충안전유효적방법,원기효과상대진일보관찰.
Objective To evaluate the utility of modified Z-stent in treatment for Budd-Chiarisyndrome (BCS). Methods A retrospective study was used in twelve BCS patients treated in twohospitals. The Doppler examination was carried out in all patients preoperatively, so as to confirm thenature of the lesion and chose correct type of endovascular modified Z-stent. Under DSA monitoring formembranotomy and dilation of the inferior vena cava(IVC), after that, insert the marked modified Z-stent to IVC correctly, and put the non-stent part to hepatic vein orifice. The cavography and hepaticvenography should confirm the position of the Z-stent. All of 12 patients with membranous obstructionof the IVC(MOVC) or segmental obstruction of the IVC (SOVC)were underwent modified Z-stentplacement. Results The IVC pressure (IVCP) before smd after membranotomy (dilation) were 27.33± 4.12cmH2O and 18.67 ± 5.07cmH2O (P＜0.01). Comparing with dilation and putting stent group,the IVCP decreased from 18.67 ± 5.07cmH2O to 11.42 ± 2.11 cmH2O ( P ＜ 0.01 ). The modffied Z-stent could avoid hepatic vein orifice getting compression and resist the retraction of IVC throughly infollowing-up period of 2.5 years. Conclusion s The endovascular treatment of BCS with modified Z-stent is more effective and safer to prevent thrombosis. Further study will be required to observe theirlong term effects.