胸部正中切口根治小儿布加综合征

Budd-Chiari'syndrome radical operation with idsternal incision in children

目的 探讨一种安全有效、根治小儿布加综合征的手术方法。方法 回顾 6例应用本项手术方式治疗的临床资料 ,总结在深低温全身麻醉、体外循环辅助下清除局部病灶的临床治疗体会。结果 在不切开胸膜腔和腹腔的情况下 ,仅行心包、下腔静脉切开 ,既可清晰显出下腔静脉或肝静脉病变 ,在暂时停循环状态下进行局部病灶切除和血管重建 ,手术后肝脏明显缩小 ,肝静脉回流通畅 ,随访 5～ 33个月 ,无 1例死亡或并发症发生 ,无 1例复发。结论 深低温停循环状态下 ,切开心包及下腔静脉 ,切除狭窄或闭塞性病变根治小儿布加综合征的手术方法安全、有效、创伤小、恢复快、符合解剖和生理需要。

Objective: To investigate the safe and effective operation on the children with Budd-Chiari syndrome. Methods:To analyze the clinic dates retrospectively, and to summary the experience of radical operative midsternal incision on the patients with Budd-Chiari syndrome. Results:The foci were clearly exposed and resected under the temporally circulatory pause with incising the pericardium and inferior vena cava only without opening the thoracic cavity or abdomen cavity. The livers diminished and the liver venous reflux became normal just after operation. All operated children were followed-up for 5～33 months, no death or severious complication and no recurrence.Conclusions: It is a better operation of safety, effectiveness, mini trauma quick recovery and according to the need of anatomical and physiological.