布加氏综合征外科治疗78例报告

SURGICAL TREATMENT OF BUDD-CHIARI SYNDROME: EXPERIENCE OF 78 CASES

目的 通过总结 78例布加氏综合征治疗方法 ,以探讨多种手术及介入方法的疗效。方法 78例中行经皮腔内血管成形术 (PTA) 18例 ,PTA加支架置入术 10例 ,脾肺固定加大网膜包肺术 2 0例 ,经右心房及股静脉联合破膜扩张并置支架术 15例 ,下腔静脉 右心房人工血管转流术 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 2 .5 0～ 3 .95kPa下降至术后 1.41～ 2 .3 3kPa ,门静脉压力由术前 3 .63～ 5 .0 0kPa下降至 2 .16～ 3 .2 3kPa。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 curative effect of operative and interventional treatment in 78 cases of Budd Chiari syndrome (BCS). Methods Among these patients, percutaneous trans inferior vena cava angioplasty (PTA) was performed in 18 cases, PTA and stent in 10 cases, splenopneumopexy plus pedicled omento pneumopexy of the left lower lobe in 20 cases, combined transcardiac membranotomy and transfemoral venous ballon dilatation and stent in 15 cases, right atrium inferior vena cava shunt in 10 cases, and radical operation plus stent in 5 cases. [WT5”HZ]Results [WT5”BZ]After the treatment, the descent of inferior vena cava (IVC) pressure from 2.50～3.95 kPa to 1.41～2.33 kPa, the descent of portal venous pressure from 3.63～5.00 kPa to 2.16～ 3.23 kPa were observed. [WT5”HZ]Conclusion [WT5”BZ]The authors consider that PTA is the first choice for localized lesions, the following method is the operation combined with interventional treatment.