Effect of thrombolytic therapy and influencing factors of Budd-Chiari syndrome with inferior vena cava thrombosis
10.3760/cma.j.cn112139-20201219-00868
- VernacularTitle:巴德-吉亚利综合征合并下腔静脉血栓形成的溶栓治疗效果及影响因素分析
- Author:
Luhao LI
1
;
Xiaowei DANG
;
Gong ZHANG
;
Lin LI
;
Suxin LI
;
Peiju WANG
;
Dongqi SHEN
;
Shengyan LIU
Author Information
1. 郑州大学第一附属医院肝胆胰外科 河南省布-加综合征诊疗中心 450052
- Keywords:
Vena cava, inferior;
Thrombolytic therapy;
Budd-Chiari syndrome;
Factor analysis, statistical
- From:
Chinese Journal of Surgery
2021;59(11):929-933
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the effect of thrombolytic therapy of Budd-Chiari syndrome (B-CS) with inferior vena cava (IVC) thrombosis, and the prognosis factors of it.Methods:The clinical data of 67 patients of B-CS with IVC thrombosis treated in the Department of Hepatopancreatobiliary Surgery, the First Affiliated Hospital of Zhengzhou University from January 2013 to August 2020 were analyzed retrospectively. There were 30 males and 37 females. The age was (47.7±11.1) years(range: 18 to 72 years). All patients received catheter directed thrombolysis, and the thrombolysis process, complications and outcomes were analyzed. All patients received IVC balloon angioplasty after thrombolytic therapy. The t test, χ 2 test, Mann-Whitney U test were used for univariate analysis of the prognosis factors of thrombolysis effects, while unconditional Logistic regression model were used for multivariate analysis. Results:In the 67 patients, 47 cases succerssed in thrombolytic therapy. The successful rates of thrombolysis at 1-, 2-, 3- and 4-week were 9.0%, 29.9%, 64.2% and 70.1%, respectively. The rates of thrombolytic catheter-related infection at 1-, 2-, 3- and 4-week were 1.5%, 4.5%, 14.9% and 31.3%, respectively. No serious complications such as symptomatic and acute pulmonary embolism occurred during perioperative period of IVC balloon angioplasty. Univariate analysis showed that differences in thrombus length ((36.7±18.1) mm vs. (52.0±16.4) mm, t=-3.234, P=0.002), Child-Pugh classification (class A/B/C: 37/8/2 vs. 10/8/2, Z=-2.310, P=0.021) and pre-opening IVC proportion (68.1% (32/47) vs. 35.0% (7/20), χ2=6.313, P=0.012) were statistically significant. The thrombus length ( OR=0.948, 95% CI: 0.913 to 0.984, P=0.005), pre-opening IVC ( OR=5.451, 95% CI: 1.469 to 20.228, P=0.011) were independent prognosis factors of thrombolytic effect. Conclusions:Thrombolytic therapy for B-CS with IVC thrombosis were satisfactory, and the thrombolysis duration should be confined within 3 weeks. IVC balloon angioplasty is safe and effective for patients failing in thrombolysis, and pre-opening IVC is an important method to improve the thrombolytic effect.
