介入治疗加肠腔C型分流术治疗布加综合征

Interventional therapy plus mesocaval C graft (M C C) shunt for the treatment of Budd Chiari syndrome

目的探讨一种对布加综合征达到联合减压目的的治疗方法。方法行下腔静脉介入治疗（球囊扩张加支架植入术）及肠系膜上静脉下腔静脉Ｃ型分流术。结果行该联合术式５例，术后肝脾肿大缩小，腹水消失或减少。下腔静脉压力降低５～１１ｃｍＨ２Ｏ。门静脉压力降低７～２４ｃｍＨ２Ｏ。４例存活，无并发症。１例术后因多器官功能衰竭死亡。随访２～２５个月，４例患者情况好，无腹水出现，恢复正常工作和生活。结论新的组合术式扩大了治疗范围，既解除了下腔静脉高压，又降低了门静脉高压，达到了联合减压的目的，手术简化，减少创伤及患者痛苦，治疗效果满意。本术式有其临床价值。

Objective To evaluate a novel combined procedure for the treatment of Budd Chiari syndrome as to achieve the goal of combined decompression. Methods Five patients with Budd Chiari Syndrome underwent interventional treatment (balloon dilatation and endovascular stents) and M C C shunt. Results The patients who underwent the combined procedure had reduced hepatosplenomegaly and ascites after operation. The IVC pressure was decreased by 5～11 cmH 2O. The portal pressure was decreased by 7～24 cmH 2O. Four patients are still alive without complication, ascites and recurrence during the follow up period of 2～25 months. One died from postoperative MOF. The clinical result is satisfactory. Conclusions We recommend the novel combined procedure,by which both IVC and portal pressure was decreased, achieving the goal of combined decompression.