中西医结合护理 (Apr 2023)
Interventional therapy and perioperative nursing management of Budd-Chiari syndrome: A report of 139 cases (布-加综合征的介入治疗及围术期护理管理: 附139例报告)
Abstract
Objective This article aims to study the effect of endovascular treatment of Budd-Chiari syndrome (BCS) and perioperative nursing experience. Methods The clinical data of 139 patients with BCS who received endovascular treatment in our hospital from December 2012 to December 2019 were retrospectively analyzed. In this article, the technical procedure was described in detail, and the perioperative complications and follow-up results were summarized. Results Totally 128 patients received endovascular therapy successfully, with a technical success rate of 92. 09%(128/139). Among them, 112 cases were simply balloon dilated and 16 cases were stent implanted. The average pressure of inferior vena cava decreased from (29. 80±6. 20) mmHg before operation to (8. 90±2. 00) mmHg after operation. Postoperative complications occurred in 9 patients, including 2 cases of pulmonary embolism, 1 case of cardiac tamponade, 1 case of vena cava rupture, 5 cases of left heart failure and pulmonary edema, and 3 cases of perioperative all-cause death (2. 16%). 114 patients were followed up after operation, with an average follow-up of 36 months. The 1-year restenosis rate after simple ball expansion was 22. 45%(22/98), and the 1-year restenosis rate after stent implantation was 12. 50%(2/16); the 3-year survival rate of patients was 90. 35%(103/114). Conclusion Endovascular technique is a safe and effective method for the treatment of BCS. The first choice for treatment is simple balloon molding. If elastic retraction and restenosis occur after balloon expansion, stent implantation can be considered. Close cooperation with perioperative nursing of BCS can promote the rapid recovery of patients. (目的 总结介入治疗布-加综合征(BCS)的效果及围术期护理体会。方法 回顾性分析2012年12月—2019年12月医院收治的139例接受介入治疗的BCS患者的临床资料。详细阐述该技术操作流程, 总结围手术期并发症及随访结果。结果 128例患者成功接收腔内介入治疗, 技术成功率92. 09%(128/139)。其中单纯球囊扩张112例, 支架植入16例。下腔静脉平均压力由术前(29. 80±6. 20)mmHg 降至术后(8. 90±2. 00)mmHg。9例患者出现术后并发症, 肺栓塞2例, 心包填塞1例, 腔静脉破裂1例, 左心衰、肺水肿5例, 围术期全因死亡3(2. 16%)例。术后114例患者得到随访, 平均术后随访36个月, 单纯球囊扩张术后1年再狭窄率22. 45%(22/98), 支架植入术后1年再狭窄率12. 50%(2/16); 患者3年的生存率90. 35%(103/114)。结论 腔内技术用于治疗BCS征是一种安全、有效的方法, 治疗首选单纯球囊成型, 如果球囊扩张后出现血管弹性回缩、再狭窄, 可考虑植入支架治疗。做好BCS围手术期护理工作, 可促进患者的快速康复。)
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