CAJ | 학술논문

目的评价采用介入开通术治疗布加综合征(BCS)合并下腔静脉(IVC)陈旧血栓的安全性及疗效.方法 2008年1月至2013年3月,采用介入开通术治疗BCS合并IVC陈旧血栓患者23例.其中男16例,女7例,年龄32～71岁,平均(51.1±11.7)岁.19例行IVC球囊扩张术,4例行球囊扩张并支架置入术,术后均口服华法林抗凝治疗.采用彩色多普勒超声观察IVC通畅情况及血栓变化.结果 23例患者均治疗成功,无肺栓塞等并发症及死亡发生.下腔静脉-右心房压差由术前的平均(27.0±3.0) cmH2O(1 cmH2O=0.098 kPa)降至术后的平均(3.5±1.2)cmH2O(t =45.8,P＜0.05).术后随访3～ 66(平均18.8±16.5)个月,彩色多普勒超声显示IVC血流通畅21例、再闭塞2例;IVC血栓完全溶解15例、部分溶解8例.结论采用介入开通术治疗布加综合征合并IVC陈旧性血栓安全、有效,可取得较好的临床疗效.
목적 평개채용개입개통술치료포가종합정(BCS)합병하강정맥(IVC)진구혈전적안전성급료효.방법 2008년1월지2013년3월,채용개입개통술치료BCS합병IVC진구혈전환자23례.기중남16례,녀7례,년령32～71세,평균(51.1±11.7)세.19례행IVC구낭확장술,4례행구낭확장병지가치입술,술후균구복화법림항응치료.채용채색다보륵초성관찰IVC통창정황급혈전변화.결과 23례환자균치료성공,무폐전새등병발증급사망발생.하강정맥-우심방압차유술전적평균(27.0±3.0) cmH2O(1 cmH2O=0.098 kPa)강지술후적평균(3.5±1.2)cmH2O(t =45.8,P＜0.05).술후수방3～ 66(평균18.8±16.5)개월,채색다보륵초성현시IVC혈류통창21례、재폐새2례;IVC혈전완전용해15례、부분용해8례.결론 채용개입개통술치료포가종합정합병IVC진구성혈전안전、유효,가취득교호적림상료효.
Objective To evaluate the clinical safety and efficacy of interventional recanalization of Budd-Chiari syndrome (BCS) due to old inferior vena cava (IVC) thrombosis.Methods Between January 2008 and March 2013,23 patients with BCS due to old IVC thrombosis (16 males and 7 females) and with a mean age of (51.1 ± 11.7) years (range 32 ～71 years) underwent interventional recanalization.IVC balloon dilation was performed in 19 patients,and balloon dilation and stenting in 4 patients.All the patients received oral anticoagulant (warfarin) after interventional recanalization.On follow-up,color Doppler ultrasound was used to examine patency of the IVC and changes in the old IVC thrombus.Results Technical success was achieved in all 23 patients.There were no complications such as pulmonary embolism and no death.The mean pressure gradient between the IVC and the right atrium reduced from (27.0 ± 3.0) cmH2O (1 cmH2 O =0.098 kPa) before treatment to (3.5 ± 1.2) cm H2 O after treatment (t =45.8,P ＜ 0.05).The follow-up period ranged from 3 to 66 (mean ± SD,18.8 ± 16.5)months after interventional recanalization.Color Doppler ultrasound showed patency in the IVC lumen in 21 patients,and IVC reocclusion occurred in 2 patients.Of the 23 patients,complete resolution of the old thrombus was achieved in 15 patients and partial resolution was achieved in 8 patients.Conclusions Interventional recanalization is a safe and efficacious therapy for BCS due to old IVC thrombosis.The treatment achieved excellent clinical efficacy.