CAJ | 학술논문

目的探讨导丝贯穿技术在肝静脉型布加综合征(BCS)介入治疗中的应用价值.方法回顾性分析2011年5月至2014年8月收治的25例肝静脉型BCS患者的临床资料.所有患者均用导丝贯穿法行肝静脉成形术.介入治疗前后测量肝静脉压力,用t检验评价治疗前后肝静脉压力的变化.结果 25例患者均成功用导丝贯穿法行肝静脉成形术.术中无血管破裂出血、心包填塞及肝包膜破裂出血等并发症发生.治疗后肝静脉压力由(48.3±8.0)cmH2O降至(20.9±3.8)cmH2O(t=26.82,P＜0.05),治疗前后差异有统计学意义.术后所有患者临床症状、体征均明显缓解或消失.随访期间有4例患者再次出现BCS相关症状.其中2例再次行球囊扩张治疗成功,1例因肝硬化失代偿改用经颈静脉肝内门体分流(TIPS)治疗,另1例因患强直性脊柱炎第三次症状复发行肝静脉开通治疗失败.结论采用导丝贯穿技术行肝静脉成形术治疗肝静脉型BCS是一种安全、有效的补充治疗方法,能提高肝静脉型BCS的治疗成功率.
목적 탐토도사관천기술재간정맥형포가종합정(BCS)개입치료중적응용개치.방법 회고성분석2011년5월지2014년8월수치적25례간정맥형BCS환자적림상자료.소유환자균용도사관천법행간정맥성형술.개입치료전후측량간정맥압력,용t검험평개치료전후간정맥압력적변화.결과 25례환자균성공용도사관천법행간정맥성형술.술중무혈관파렬출혈、심포전새급간포막파렬출혈등병발증발생.치료후간정맥압력유(48.3±8.0)cmH2O강지(20.9±3.8)cmH2O(t=26.82,P＜0.05),치료전후차이유통계학의의.술후소유환자림상증상、체정균명현완해혹소실.수방기간유4례환자재차출현BCS상관증상.기중2례재차행구낭확장치료성공,1례인간경화실대상개용경경정맥간내문체분류(TIPS)치료,령1례인환강직성척주염제삼차증상복발행간정맥개통치료실패.결론 채용도사관천기술행간정맥성형술치료간정맥형BCS시일충안전、유효적보충치료방법,능제고간정맥형BCS적치료성공솔.
Objective To investigate the value of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction.Methods A retrospective study was conducted on 25 patients with Budd-Chiari syndrome (BCS) with hepatic vein obstruction treated from May 2011 to August 2014.The technique of guide-wire loop was used in these patients.The pressure of the hepatic vein was measured before and after treatment.The difference in the pressure was analyzed by the t test.Results All the patients were treated successfully using guide-wire loop angioplasty.No complications of bleeding,pericardial tamponade and liver capsule hemorrhage were observed.After treatment,the pressure of the hepatic vein reduced from (48.3± 8.0) cmH2O to (20.9 ± 3.8) cmH2O (t =26.82,P ＜ 0.05);The symptoms and physical signs of the patients were relieved or disappeared.BCS-related symptoms reappeared on follow-up in 4 patients,2 were treated by balloon dilation successfully.1 patient was treated with transjugular intrahepatic portosystemic shunt (TIPS) because of decompensated liver cirrhosis.1 patient with ankylosing spondylitis had treatment failure and the symptoms relapsed for the third time.Conclusion The technique of guide-wire loop in interventional therapy of patients with Budd-Chiari syndrome with hepatic vein obstruction is safe and effective,and it can improve the overall success rate of treatment.