| 林锐,吴刚.序贯介入治疗Budd-Chiari综合征合并下腔静脉新鲜血栓[J].中国介入影像与治疗学,2021,18(7):389-392 |
| 序贯介入治疗Budd-Chiari综合征合并下腔静脉新鲜血栓 |
| Sequential interventional therapy of Budd-Chiari syndrome complicated with fresh inferior vena cava thrombi |
| 投稿时间：2020-12-24 修订日期：2021-06-07 |
| DOI：10.13929/j.issn.1672-8475.2021.07.002 |
| 中文关键词: Budd-Chiari综合征 血栓形成 血管扩张成形 溶栓 介入放射学 |
| 英文关键词:Budd-Chiari syndrome thrombosis angioplasty thrombolysis interventional radiology |
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| 中文摘要: |
| 目的 观察序贯介入治疗Budd-Chiari综合征合并下腔静脉（IVC）新鲜血栓的有效性及安全性。方法 对27例Budd-Chiari综合征合并IVC新鲜血栓患者行小球囊预扩张、置管溶栓及大球囊扩张等序贯介入治疗；记录不良反应；术后随访复查超声，评估治疗效果。结果 对27例均以直径10~14 mm小球囊预扩张IVC闭塞段，扩张后原闭塞段血流均部分恢复；经留置溶栓导管泵入尿激酶40~60×104U/d、平均（44.10±8.40）×104U/d，持续4~15天、平均（6.72±5.21）天后，超声显示20例IVC内血栓完全消失，7例仍残留少量陈旧血栓；以大球囊（直径25~30 mm）扩张IVC原狭窄段，之后IVC血流恢复，侧支血管明显减少或消失。围手术期未见肺栓塞、大出血等严重并发症。术后平均随访（20.22±18.43）个月，27例患者均存活，相关临床症状及体征消失或不同程度缓解。结论 序贯介入治疗Budd-Chiari综合征合并IVC新鲜血栓安全、有效。 |
| 英文摘要: |
| Objective To observe the safety and efficacy of sequential interventional therapy for Budd-Chiari syndrome (BCS) complicated with fresh inferior vena cava thrombosis. Methods Totally 27 patients with BCS complicated with fresh IVC thrombosis who received sequential interventional therapy. The specific method was to pre-dilate the IVC occlusion segment with a small balloon first, and then place thrombolytic catheter for local thrombolysis. After thrombolysis was complete or nearly complete, the stenosis segment was dilated with large balloon. Therapeutic effects and adverse effects were recorded. Results All patients were treated with small balloon catheters (diameter 10-14 mm) to pre-dilate the occlusive segment of IVC, the IVC occlusion segment was partially restored after dilation. After operation, micropump was used to pump urokinase through an indwelling thrombolytic catheter for 40-60×104 U/d, the average was (44.10±8.40)×104 U/d, and catheterization for 4-15 (6.72±5.21)d. Ultrasound re-examination showed that IVC thrombosis disappeared completely in 20 patients, and a small amount of the old thrombus remained in 7 patients. After thrombolysis, all patients received large balloon dilation (diameter, 25-30 mm) in stenotic IVC segment, and the blood flow recovered subsequently, collateral vessels were significantly reduced or disappeared. No serious complication such as pulmonary embolism and massive hemorrhage occurred during the perioperative period. The mean postoperative follow-up was (20.22±18.43) months. All the 27 patients survived, and their clinical symptoms and signs were relieved or disappeared to varying degrees. Conclusion Sequential interventional therapy for BCS complicated with fresh inferior vena cava thrombosis was safe and effective. |
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