摘要
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.
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.
出处
《国际外科学杂志》
2014年第12期816-820,共5页
International Journal of Surgery
基金
基金项目：郑州市科技领军人才项目（No.131PLJRC669）
关键词
布加综合征
置管溶栓
下腔静脉
血栓栓塞
手术后并发症
Budd-Chiari syndrome
Thrombolytic catheter
Inferior vena cava
Thromboembolism
Postoperative complications
