Budd-Chiari 综合征手术治疗71例分析

Surgical treatment of 71 cases with Budd Chiari syndrome

目的：采用不同的手术方法对７１例布加综合征进行治疗。本文就此组病人的治疗结果进行总结，以探讨几种常用术式的优缺点及适应症。方法：依靠病理类型的不同而采用不同的治疗方法。其中经皮球囊扩张２６例；内置金属支架２０例；隔膜切除、心包片成形术１４例；闭塞段切除、人工血管原位移植１２例；各种转流手术１６例。结果：随访有５３例显效，７例复发。结论：经皮球囊扩张术主要适用于隔膜型及短段狭窄型，而隔膜切除、心包片成形术有被球囊导管扩张术取代的趋势，闭塞段切除、人工血管原位移植则能克服以往术式的缺点，对于短段闭塞型及重度下腔静脉狭窄型有良好疗效。

Objective:To present the results of various methods of surigcal treatment for 71 cases with Budd Chiari syndrome(BCS) and to discuss their advantages and disadvantages and indications.Methods:According to their type of pathological changes,26 cases were treated with balloon catheter dilatation,20 cases with intravascular stent,14 cases with radical resection of membranous obstruction and pericardiac repair,12 cases with radical resection of short segmental obstruction with vascular graft in the original position,16 cases with various shunts.Results:Good results in 53 cases,with only 7 cases recurring.Conclusions:Balloon catheter dilatation mainly for membranous type and with localized stenosis.Radical resection of membranous obstruction and pericardiac repair can be replaced by balloon catheter dilatation.The using of vascular graft in original position can avoid the disadvantages of the operative methods used before and have good curative effects on short segmental obstruction and severe stenosis.