摘要
通过对６３例Ｂｕｄｄ－Ｃｈｉａｒｉ综合征的病理特征、临床分型方法、诊断及治疗的分析，本组病例造影表现为单纯肝静脉阻塞，下腔静脉膜性狭窄、闭塞，节段性狭窄、闭塞５例。临床上可分为肝静脉阻塞型、下腔静脉阻塞型、下腔静脉并肝静脉阻塞型；为避免误诊，特提出下肢静脉曲张型。研究发现，下腔静脉和肝静脉膜性阻塞时，隔膜中多数存在一个薄弱点或小孔；下腔静脉节段性闭塞时，闭塞段多数存在潜在腔隙，但部分病例闭塞段呈条索状。结论：本病各型的临床特点不同。造影及Ｂ超为首选确诊方法。新的病理发现利于介入治疗，建议将介入疗法作为首选，介入治疗不能解决的部分肝静脉闭塞和下腔静脉节段性闭塞者采用外科手术为佳。
Analysing 63 cases of Budd-Chiari syndrome(BCS),putting forward some new pathologic features,new clinical classification and opinion about diagnosis and treatment of this disease.The results showed that the under angiography,they could be classified as 5 types:pure hepatic veno-occlusive type,membranous stenosis or occlusion of inferior vena cava(IVC),segmental stenosis or occlusion of IVC.Clinically they were classified as :type of hepatic veno-occlusion,of IVC occlusion,of hepatic and IVC occlusion;for avoiding misdiagnosis,the type of lower extremity varicosis was proposed.During angiography and interventional treatment,we found that there was a weak point or hole on the membrane obstructing the hepatic veins or IVC,and there was a potential space in the majority of segmental occlusive IVC,but in the minority there was no such space.It suggests there are different clinical features in different types.For making diagnosis,angiography and ultrasonography are of the first choice.Different types of this disease should be treated by different methods.Interventional treatment is proposed to be the first chioce.In case of failure,surgical alteration is necessary.
