国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2014年
12期
816-820
,共5页
党晓卫%李素新%李路豪%李海%徐韶凯%许培钦
黨曉衛%李素新%李路豪%李海%徐韶凱%許培欽
당효위%리소신%리로호%리해%서소개%허배흠
布加综合征%置管溶栓%下腔静脉%血栓栓塞%手术后并发症
佈加綜閤徵%置管溶栓%下腔靜脈%血栓栓塞%手術後併髮癥
포가종합정%치관용전%하강정맥%혈전전새%수술후병발증
Budd-Chiari syndrome%Thrombolytic catheter%Inferior vena cava%Thromboembolism%Postoperative complications
目的 探讨置管溶栓术在治疗布加综合征合并下腔静脉血栓中的可行性及安全性.方法 回顾性分析郑州大学第一附属医院2011年1月-2014年9月收治的21例布加综合征合并下腔静脉血栓患者的临床资料.其中新鲜血栓组12例,陈旧性血栓组9例.均经右侧股静脉置管,定期行彩色多普勒超声检查,评估溶栓效果,血栓完全溶解后二期行介入或(和)手术治疗,术后随访.结果 所有溶栓患者中,16例15 d内血栓完全溶解(其中新鲜血栓组9例,陈旧性血栓组7例,P=0.536).1例置管溶栓20 d,血栓完全溶解.有3例因溶栓效果不佳联合预开通技术(血栓完全溶解).血栓完全溶解时,新鲜血栓组平均置管时间为(10.78±2.97)d,陈旧性血栓组平均置管时间为(14.13±3.41)d,P=0.06.血栓短期(≤15 d)完全溶解率为76.19％(16/21),溶栓总有效率为90.48％(19/21).溶栓期间4例出现并发症,严重并发症发病率为4.76％(1/21).术后随访1～12个月,定期彩色多普勒超声检查,1例术后5个月复发,其余均未见复发,随访时间内复发率为4.76％(1/21).结论 置管溶栓术作为治疗布加综合征合并下腔静脉血栓的一个重要环节,操作简单、安全有效,并发症发病率低,可作为此类型布加综合征的首选治疗方案.
目的 探討置管溶栓術在治療佈加綜閤徵閤併下腔靜脈血栓中的可行性及安全性.方法 迴顧性分析鄭州大學第一附屬醫院2011年1月-2014年9月收治的21例佈加綜閤徵閤併下腔靜脈血栓患者的臨床資料.其中新鮮血栓組12例,陳舊性血栓組9例.均經右側股靜脈置管,定期行綵色多普勒超聲檢查,評估溶栓效果,血栓完全溶解後二期行介入或(和)手術治療,術後隨訪.結果 所有溶栓患者中,16例15 d內血栓完全溶解(其中新鮮血栓組9例,陳舊性血栓組7例,P=0.536).1例置管溶栓20 d,血栓完全溶解.有3例因溶栓效果不佳聯閤預開通技術(血栓完全溶解).血栓完全溶解時,新鮮血栓組平均置管時間為(10.78±2.97)d,陳舊性血栓組平均置管時間為(14.13±3.41)d,P=0.06.血栓短期(≤15 d)完全溶解率為76.19％(16/21),溶栓總有效率為90.48％(19/21).溶栓期間4例齣現併髮癥,嚴重併髮癥髮病率為4.76％(1/21).術後隨訪1～12箇月,定期綵色多普勒超聲檢查,1例術後5箇月複髮,其餘均未見複髮,隨訪時間內複髮率為4.76％(1/21).結論 置管溶栓術作為治療佈加綜閤徵閤併下腔靜脈血栓的一箇重要環節,操作簡單、安全有效,併髮癥髮病率低,可作為此類型佈加綜閤徵的首選治療方案.
목적 탐토치관용전술재치료포가종합정합병하강정맥혈전중적가행성급안전성.방법 회고성분석정주대학제일부속의원2011년1월-2014년9월수치적21례포가종합정합병하강정맥혈전환자적림상자료.기중신선혈전조12례,진구성혈전조9례.균경우측고정맥치관,정기행채색다보륵초성검사,평고용전효과,혈전완전용해후이기행개입혹(화)수술치료,술후수방.결과 소유용전환자중,16례15 d내혈전완전용해(기중신선혈전조9례,진구성혈전조7례,P=0.536).1례치관용전20 d,혈전완전용해.유3례인용전효과불가연합예개통기술(혈전완전용해).혈전완전용해시,신선혈전조평균치관시간위(10.78±2.97)d,진구성혈전조평균치관시간위(14.13±3.41)d,P=0.06.혈전단기(≤15 d)완전용해솔위76.19％(16/21),용전총유효솔위90.48％(19/21).용전기간4례출현병발증,엄중병발증발병솔위4.76％(1/21).술후수방1～12개월,정기채색다보륵초성검사,1례술후5개월복발,기여균미견복발,수방시간내복발솔위4.76％(1/21).결론 치관용전술작위치료포가종합정합병하강정맥혈전적일개중요배절,조작간단、안전유효,병발증발병솔저,가작위차류형포가종합정적수선치료방안.
Objective To investigate the feasibility and safety of catheter thrombolysis in the treatment of Budd-Chiari syndrome (B-CS) with inferior vena cava(IVC) thrombosis.Methods A retrospective analysis of the clinical data of 21 cases of B-CS with IVC thrombosis in the First Affiliated Hospital of Zhengzhou University from January 2011 to September 2014 was conducted.They were divided into 2 groups,12 cases of fresh thrombus group,while 9 cases of old thrombus group.All cases were couducted with catheter directed thrombolysis through the right femoral vein,then regularly with color doppler examination,evaluating thrombolytic effect.When thrombus disappearing,intervention or (and) operation treatment was conducted,then postoperative following-up.Results There were 16 cases in which thrombus dissolving completely within 15 days(9 cases of fresh thrombus and 7 cases of old thrombus,P =0.536).In 1 case,thrombosis dissolved completely 20 days later.There were 3 cases combined with pre-dilating technology (thrombosis dissolved completely).When thrombosis completely dissolved,the mean catheterization time of fresh thrombus group was (10.78 ± 2.97)d,while the old thrombus group was (14.13 ± 3.41)d(P =0.06).The short-term (less than 15 days) dissolution rate was 76.19％ (16/21),and the total efficiency rate was 90.48％ (19/21).Complications occurred in 4 cases.The incidence of severe complications was 4.76％ (1/21).Postoperative follow-up with Color Doppler ultrasound in 1 to 12 months,1 case recurred after 5 months.The rest did not recurred.the recurrence rate was 4.76％ (1/21) within following up time.Conclusions The catheter thrombolysis is an important link in the treatment of B-CS with thrombosis of IVC,which is simple,safe and effective,with low incidence of complications.It can be used as the preferred treatment for this type of B-CS.
