合并布-加氏综合征的原发性肝癌的外科治疗

Surgical treatment of primary liver carcinoma complicated with Budd-Chiari syndrome

目的探讨合并布-加氏综合征的原发性肝癌的临床特征及治疗方法的选择。方法回顾性分析我科9例合并布-加氏综合征的原发性肝癌患者资料,分析临床特点及治疗方式的选择和预后。结果 9例患者中8例行肝癌切除治疗联合下腔静脉破膜球囊扩张或支架植入,1例既往2年前行BCS介入治疗后再发HCC行肿瘤切除,术后下肢水肿消失,曲张静脉好转,溃疡愈合,随访至今,无一例死亡,6例下腔静脉通畅,1例患者术后半年出现下腔静脉再次闭锁,行第二次下腔静脉球囊扩张支架植入治疗,1例术后12月肿瘤复发行TACE治疗。结论有效缓解症状,延长病人生存期,是临床治疗的理想选择,值得临床推广应用。

Objective To explore the clinical features and surgical treatment of Primary liver carcinoma complicated with Budd-Chiari syndrome. Methods Making a retrospective analysis of the clinical data, clinical features, approaches to treatment and prognosis of 9 patients with Primary liver carcinoma complicated with Budd-Chiari syndrome. Results 9 patients after hepatectomy combined with intraluminal dilatation or stenting on postcava with symptoms that limb oedema disappeared, varices relieved and ulcer was clear. All patients were followed up and no single case died to this day. Inferior vena cava were patent in 6 cases, the symptoms of obstruction of inferior vena cava were discovered in 1 case within 6 months after operation and undergone secondary intraluminal dila- tation or stenting on postcava treatment. 1 patient underwent transcatheter arterial chemoembolization 12 months after operation because of the tumor recurrence. Conclusion Hepatectomy combined with intraluminal dilatation or stenting on postcava is an ideal selection in clinical treatment. It can effectively relieve the symptoms and prolong the survival time of patients and worthy of being widely applied in clinic.