布-加综合征的诊断治疗59例

Diagnosis and treatment of Budd-Chiari syndrome: An analysis of 59 cases

目的:分析布-加综合征(Budd-Chiari syndrome,BCS)的临床特点,提供该综合征的诊断治疗经验.方法:对59例BCS患者进行临床症状、体征、实验室检查、影像学检查及治疗情况进行回顾性分析.结果:59例患者主要临床表现为双下肢水肿17例,占28.8%,腹胀15例,占25.4%,腹胀伴双下肢水肿7例,占11.9%,彩色多普勒血管超声和血管造影的诊断率可达100%.55例患者行介入治疗,出院转归治愈23例,好转30例,未愈2例.结论:BCS的临床表现繁杂,极易误诊误治,对高度怀疑本病者,应行彩超多普勒血管检查和静脉造影进行确诊,早期诊断及治疗对预后有重要的影响.介入手术是有效的治疗手段.

AIM： To analyze the clinical characteristics of Budd-Chiari syndrome to improve clinical awareness and diagnosis of this disease. METHODS： The clinical data for 59 patients diagnosed with Budd-Chiari syndrome were reviewed retrospectively to analyze patients’ clinical symptoms, signs, laboratory examination, iconography examination and treatment. RESULTS： Main clinical manifestations included lower-limb edema （17/59, 28.8%）, abdominal distention （15/59, 25.4%）, and abdominal distention with lower limb edema （7/59, 11.9%）. The rate of diagnosis of Budd-Chiari syndrome by color Doppler vascular ultrasound and angiography was nearly 100%. Of 55 patients undergoing interventional therapy, 23 were cured, 30 had improved condition, and 2 had no significant improvement. CONCLUSION： Clinical manifestations of Budd-Chiari syndrome are complicated, which often leads to misdiagnosis and mistreatment. For patients highly suspected of having this disease, color Doppler vascular examination and venography should be conducted for diagnosis. Early diagnosis and treatment are important for prognosis. Interventional therapy is an effective method for Budd-Chiari syndrome.