论文部分内容阅读
目的：探讨肿瘤性布－加氏综合征的内支架治疗之疗效及术后处理。方法： 58例肿瘤性布－加氏综合征病人 (原发性肝癌 39例，巨大肝血管瘤 3例，转移性肝癌 9例，肾癌 7例 )有完整随访资料。先用导丝通过狭窄段或潜在的缝隙行球囊扩张，后置入 Gianturco Z型支架或网状支架。结果： 58例中 56例开通成功， 2例因导丝无法通过完全阻塞的下腔静脉而失败，开通成功率 96.6％。 2例病人因狭窄段超过 10 cm而植入两个支架，其余病人均植入一个支架。开通后下腔静脉压由术前 (2.82± 0.40) kPa降至 (1.67± 0.43) kPa (1 kPa=10.2 cm H2O)，经统计学处理，开通前后下腔静脉压变化有显著意义( P<0.01).开通后造影示下腔静脉管径接近正常，轮廓光整，下腔静脉狭窄或阻塞所致的临床症状及体征在3~4天内迅速消退，总有效率100%；术中及术后未出现严重并发症。结论：支架植入治疗肿瘤性布-加氏综合征是一种安全有效的方法。
Objective: To investigate the curative effect and post-operative treatment of endovascular stent-graft treated with tumor of Budd-Chiari syndrome. Methods: Complete follow-up data were obtained from 58 cases of patients with tumorous Budd-Chiari syndrome (39 cases of primary liver cancer, 3 cases of giant hepatic hemangioma, 9 cases of metastatic liver cancer and 7 cases of kidney cancer). The balloon is expanded with a guide wire through the stenosis or potential gap and placed into a Gianturco Z stent or mesh stent. Results: Of the 58 cases, 56 cases were successfully opened, 2 cases failed because the guide wire failed to pass completely obstructed inferior vena cava, and the successful rate was 96.6%. Two patients were implanted with two stents due to the stenosis of more than 10 cm, and the rest of the patients were implanted with a stent. After opening, the pressure of IVC decreased from (2.82 ± 0.40) kPa to (1.67 ± 0.43) kPa (1 kPa = 10.2 cm H2O). Statistically, the change of IVC was significant (P < 0.01) .After the opening angiography shows that the diameter of the inferior vena cava is close to normal, contouring, inferior vena cava stenosis or obstruction caused by clinical symptoms and signs of rapid subside within 3 to 4 days, the total efficiency of 100%; intraoperative and surgical No serious complications occurred. Conclusion: Stent implantation is a safe and effective method for the treatment of neoplastic.