布-加综合征再手术的术前处理和术式选择

Preoperative management and Methods of second operation for Budd-Chiari syndrome

目的 探讨布 加综合征 (B CS)再手术的术前处理原则和手术方式的选择。方法 对 2 0 1例再手术B CS病人的临床资料进行回顾性分析。结果 其中Ⅰa型 60例 ,Ⅰb型 44例 ,Ⅱ型 5 3例 ,Ⅲa型 2 4例 ,Ⅲb型 2 0例 ,2次以上手术后再复发 3 2例。再次手术均获成功。随访 172例 ,随访时间 :6个月至 10年 ,有效率 87 8% ,复发率 4 1% ,死亡 6例。结论 布 加综合征术前要充分做好准备 ,掌握全身病理情况 ,正确进行分型。根据病理分型选择恰当的手术方法 ,术中血管吻合采用间断、褥式、外翻缝合方法等对防止术后复发也很重要。

Objective To investigate the principle of preoperative management and methods of second operation for Budd Chiari syndrome(B CS). Methods The clinical data of 201 B CS patients needed reopration were studied retrospectively,including type Ia 60 cases,type Ⅰb 44 cases,type Ⅱ 53 cases,type Ⅲa 24 cases,type Ⅲb 20 cases.Of them,32 patients who underwent two or more operations got recurrent.Results Second operation were all successful.No patient died in perioperation.One hundred seventy two cases were follow up from 6 months to 10 years.Effective rate was 87 8% ,recurrence rate was 4 1%,6 cases died.Conclusion We must take correct classification and careful preparation,grasp pathological condition for B CS before operation.Then select reasonable operative methods,depending on classification.Taking interrupt,matress,eversion suture for blood vessel are important to prevent the recurrence after B CS operation.