摘要
目的探讨分期递增式球囊扩张术治疗布加综合征(BCS)合并下腔静脉血栓的临床疗效及安全性。方法62例BCS合并下腔静脉血栓患者,均使用分期递增式球囊扩张术进行治疗。分析治疗结果(小球囊预开通成功率、血栓溶解率、并发症发生情况及死亡情况);比较手术前后实验室指标[白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)、白蛋白(ALB)、血小板计数(PLT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、直接胆红素(DBil)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]。结果62例患者中,小球囊预开通成功率为61例(98.39%),有1例因下腔静脉长段闭塞而反复扩张无法开通;其中,新鲜血栓25例,均行经导管溶栓后清除,其余为陈旧性血栓,在1个月内完全溶解率为93.44%(57/61);所有患者围术期均未发生无症状性肺栓塞、死亡病例。患者术后PLT(131.65±37.02)×10^(9)/L、HDL-C(1.15±0.21)mmol/L均高于术前的(108.94±46.36)×10^(9)/L、(0.93±0.28)mmol/L,ALP(88.19±40.63)U/L、DBil(21.02±7.59)μmol/L均低于术前的(111.57±57.48)U/L、(24.89±9.98)μmol/L(P<0.05);手术前后WBC、RBC、Hb、ALB、ALT、AST、TC水平相比无明显差异(P>0.05)。结论在BCS合并下腔静脉血栓患者的治疗中,分期递增式球囊扩张术的临床疗效显著,手术成功率及血栓溶解率高,并发症发生率低,能有效调节PLT、HDL-C等水平,对改善预后有积极意义。
Objective To explore the clinical efficacy and safety of staged incremental balloon dilation for the treatment of Budd Chiari syndrome(BCS)with inferior vena cava thrombosis.Methods 62 patients with BCS complicated with inferior vena cava thrombosis were treated with staged incremental balloon dilation surgery,and the treatment outcomes(success rate of balloon preopening,thrombolysis rate,complications,and death)were analyzed.The laboratory parameters[white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),albumin(ALB),platelet count(PLT),alanine aminotrasferase(ALT),aspartate transaminase(AST),alkaline phosphatase(ALP),direct bilirubin(DBil),total cholesterol(TC)and high density lipoprotein cholesterol(HDL-C)]were compared before and after surgery.Results Among the 62 patients,the success rate of balloon preopening was 98.39%(61/62),and 1 patient was unable to open due to repeated dilation of the long segment of the inferior vena cava due to occlusion;among them,25 cases of fresh thrombi were cleared after catheter thrombolysis,while the rest were old thrombi with a complete thrombolysis rate of 93.44%(57/61)within 1 month;all patients had no symptomatic pulmonary embolism or death cases during the perioperative period.After surgery,PLT and HDL-C were(131.65±37.02)×10^(9)/L and(1.15±0.21)mmol/L,which were higher than(108.94±46.36)×10^(9)/L and(0.93±0.28)mmol/L before surgery;while ALP and DBil were(88.19±40.63)U/L and(21.02±7.59)μmol/L,which were lower than(111.57±57.48)U/L and(24.89±9.98)μmol/L before surgery(P<0.05).There was no significant difference in WBC,RBC,Hb,ALB,ALT,AST,and TC before and after surgery(P>0.05).Conclusion The clinical efficacy of staged incremental balloon dilation in the treatment of BCS complicated with inferior vena cava thrombosis is significant.The success rate and thrombolysis rate of the surgery are high,and the incidence of complications is low.It can effectively regulate the levels of PLT,HDL-C,and has positive significance in improving prognosis.
作者
徐超
万其
杨兆丰
官泽宇
XU Chao;WAN Qi;YANG Zhao-feng(Vascular Surgery Department,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《中国现代药物应用》
2024年第10期51-54,共4页
Chinese Journal of Modern Drug Application
基金
安徽省高等学校科学研究项目(项目编号:2022AH0491)
2021年度蚌埠医学院科技项目(项目编号:2021byzd168)。
关键词
布加综合征
下腔静脉血栓
球囊扩张术
临床疗效
安全性
Budd Chiari syndrome
Inferior vena cava thrombosis
Balloon dilation
Clinical efficacy
Safety
