The Curative Effect Analysis And Research Of Inferior Vena Cava Stent Implantation In The Treatment Of Budd Chiari Syndrome

Objective: To explore the operation effect of inferior vena cava stent implantation(IVC-Stent)on the treatment of Budd Chiari syndrome.Study on clinical significance of patients in Budd Chiari syndrome,who accepted stent implantation of inferior vena cava,and study on the changes of postoperative functional.Methods: This study is divided into two parts,the Newcastle-Ottawa Scale evaluation method was used in the first part,through searching the keywords "Budd-chiari" and "IVC" and "stent" in Pubmed,CNKI database retrieval,collected at home and abroad on the inferior vena cava,complete embolization,stenosis of Budd Chiari syndrome with inferior vena cava vascular stenting treatment,which was published from January 2000 to January 2018.Collected and analyzed academic data,and Meta analysis was performed for restenosis and reocclusion after balloon angioplasty and stent implantation.The second part,through the observation of Budd Chiari syndrome in patients with clinical symptoms,and blood and liver and lung function testing,analysis of the changes of serum total bilirubin,serum albumin,prothrombin levels,comparison in the FVC values of MVV,FEV1,PEF,FEV1.0/FVC before and after surgery,the study of our hospital patients with Budd Chiari syndrome of inferior vena cava after stent implantation in clinical effect was proved.Results:1.META analysis: according to the inclusion criteria,21 literatures were identified,among which including 12 English documents,9 Chinese documents,totaling 1718 cases.The experimental group is inferior vena cava inferior vena cava stent in the treatment of Budd Chiari syndrome(IVC-BCS)group(IVC-Stent group)which include 826 cases,the control group with inferior vena cava percutaneous balloon angioplasty of inferior vena cava(IVC-PTA)treatment of Budd Chiari syndrome(IVC-BCS)group have 892 cases.The results of Meta analysis showed that:(1)the immediate clinical efficiency was 97.57% in group IVC-Stent and 97.31% in group IVC-PTA.There was no statistical difference between the two groups.(2)the rate of re embolization and re-blockage in group IVC-Stent was significantly lower than that in IVC-PTA group.In addition,many studies showed that PTA could be used to recur after B-CS recurrence.(3)the incidence of complications in the surgical treatment of B-CS syndrome,the major complication include puncture bleeding,abdominal bleeding,ascites swelling,pericardial tamponade,stent loss and so on,secondary liver failure,postoperative renal failure would be appeared in those patient,severe cases can lead to death,META analysis results showed that the test group compared with the control group no statistically significant.2.Clinical case analysis: 35 clinical cases collected randomly in our hospital,who was diagnosed with Budd Chiari syndrome and treated with inferior vena cava stent implantation.Through observing clinical symptoms after one month after the operation,found patients with ascites,edema of lower limbs and abdominal varicose veins and etc.was improved significantly,serum total bilirubin levels were significantly decreased,while serum albumin content increased evidently,prothrombin time shortened,the difference was statistically significant(t=1.95,2.31,P<0.01);in pulmonary function index,FEV1,FVC,MVV,PEF and FEV1.0/FVC were significantly increased,the difference was statistically significant(t=1.83,2.69,1.47,1.69,1.97,P=0.041,0.029,0.046,0.043,0.038).Conclusion:1.META analysis: the recurrence rate of IVC-Stent treatment for IVC-BCS syndrome is lower than that of the simple IVC-PTA treatment group,but the complication is not statistically significant.The main complication of IVC-Stent group is stent fall off,which is easy to create two vascular blockage and cause sequelae.Due to the reasons of literature quantity and quality problems,IVC-Stent treatment of inferior vena cava Budd Chiari syndrome curative effect research needs to be strengthened.2.Clinical case analysis: the results showed that vascular implantation can effectively improve the symptoms of patients with Budd Chiari syndrome,reduce the damage of lung and liver function.