Clinical Study Of Staged Incremental Balloon Dilatation In The Treatment Of Budd-Chiari Syndrome With Inferior Vena Cava Thrombosis

Objective To evaluate the clinical efficacy and safety of staged incremental balloon dilatation in the treatment of Budd-Chiari syndrome with inferior vena cava thrombosis,and to provide reference for clinical decision-making.Methods The clinical data of 92 patients with Budd-Chiari syndrome complicated with inferior vena cava thrombosis treated by staged incremental balloon dilatation from January 2010 to January 2018 were retrospectively analyzed and compared with those with simple Budd-Chiari syndrome who were hospitalized in the same period,to explore the risk factors associated with the occurrence of inferior vena cava thrombosis,to count and calculate the technical success rate,perioperative mortality,PE incidence,complications of surgery,improvement of clinical symptoms and related laboratory indexes before and after surgery,the factors that affect the survival of the patient are analyzed.Results 1.The technical success rate of pre-opening of small balloon was 97.87%,there was no patient death and symptomatic pulmonary embolism during perioperative period.After pre-opening of small balloon,the complete thrombolysis rate was 92% in one month;2.The clinical symptoms of the patients with pre-opening of small balloon were improved to some extent,the platelet and high density lipoprotein in the patients were higher than those before operation,and the levels of ALP and bilirubin were lower than those before operation,the difference was statistically significant(P<0.05);3.The cumulative first-stage patency rate was 87%,77%,58%,and the cumulative second-stage patency rate was 96%,89% and 86% in 1years,3 years and 5 years;4.There was a significant correlation between the reduction of high density lipoprotein and the thrombosis in patients with Budd-Chiari syndrome;5.The cumulative survival rate of patients at 1 year,3 years and 5 years is 95%,89%and 87%,the confirmed treatment time,restenosis times,total bilirubin and platelet count are factors that influence the prognosis of patients.Conclusion 1.It is safe and effective to use the staged incremental balloon dilatation to treat patients with Budd-Chiari syndrome complicated with inferior vena cava thrombosis;2.There is a significant correlation between the reduction of high density lipoprotein and the thrombosis in patients with Budd-Chiari syndrome;3.Early diagnosis and early treatment can improve the survival prognosis of patients with Budd-Chiari syndrome complicated with inferior vena cava thrombosis.