布-加综合征的外科治疗

Surgical treatment of Budd-Chiari syndrome

目的 分析多种手术及介入方法治疗布加综合征的疗效。方法 113例中行经皮腔内血管成形术(PTA)22例,PTA加支架置术术16例,脾肺固定加大网膜包肺术27例,经右房及股静脉联合破膜扩张并置支架术33例,下腔静脉右房人工血管转流术10例,直视根治加支架置入术5例。结果 术后病情缓解,下腔静脉压力由术前26～40cmH2O下降至术后15～25cmH2O,门静脉压力由术前37～51cmH2O下降至术后22～33cmH2O。结论 对下腔静脉或肝静脉膜性阻塞或狭窄且无新鲜血栓者,PTA加支架置入为首选措施,不宜用此法的患者以选择适当的手术加介入治疗为佳。

Objective To study the effect of operative and interventional treatment of Budd Chiari syndrome(BCS). Methods Abstract: Objective To study the effect of operative and interventional treatment of Budd Chiari syndrome(BCS). Methods Among these patients, there were percutaneous PTA and stent placement in 16 cases, splenopneumoexy and lung budled by greater omentum in 27 cases, combined transcardiac membranotomy and transfemoral venous ballon dilatation and stent placement in 33 cases, right atrium inferior vena cava shunt in 10 cases, radical operation and stent placement in 5 cases. Results After the treatment, the inferior vena cava(IVC) pressure declined from 26～40?cmH 2O to 15～25?cmH 2O, the portal venous pressure declined from 37～51?cmH 2O to 22～33?cmH 2O. Conclusions The PTA is the first choice for localized lesions of BCS; while the alternative treatment for patients unable to get PTA traetment should choose operation combining interventional therapy.