上腔静脉综合征的诊断与外科治疗(附27例报告)  

Diagnosis and surgical treatment of superior vena cava syndrome:report of 27 cases

作　　者：刘振邦[1] 董兵[1] 陈东红[1] 李简 邓高月[1] 

机构地区：[1]解放军305医院胸外科,北京100017

出　　处：《临床外科杂志》2005年第4期237-238,共2页Journal of Clinical Surgery

摘　　要：目的　总结上腔静脉综合征(superiorvenacanasyndrome ,SVCS)的外科诊治经验,提高手术成功率。方法　2 7例SVCS患者,13例在腔内转流下,采用自体心包补片加宽上腔静脉;5例在腔外转流下,采用自体心包成形血管,间置上腔静脉;3例采用人造血管置换上腔静脉;2例行人造血管转流;4例在阻断带完全阻断上腔静脉下行上腔静脉成形。结果　术后患者均恢复顺利,解除上腔静脉回流受阻满意,平均上腔静脉压由术前的2 3 .4cmH2 O降至术后的9.6cmH2 O。凡良性疾病引起的上腔静脉阻塞均得到根治,恶性肿瘤所致上腔静脉阻塞手术后改善了患者生存质量。结论　任何疾病所致上腔静脉阻塞,选择性采取手术治疗是必要的。自体心包替代上腔静脉组织相容性强,不易形成血栓及退变,在腔内或腔外转流下进行手术,可有效预防脑组织损害。Objective To provide an overview of diagnosis and surgical treatment of 27 patients with superior vena cava syndrome (SVCS).Methods Twenty-seven cases of SVCS underwent surgical treatments including cavoplasty with autologous pericardia patch and bypass grafting or interposition with prosthetic tube graft.All operations were performed while the blood flow of SVC was blocked or intercava or extracava shunt was employed.Results In all cases,occlusions of SVC were resolved.Average pressure of SVC was decreased from 23.4 cmH 2O before operation to 9.6 cmH 2O after operation.Conclusion Selective operation is necessary for the SVCS caused by different diseases.Thrombosis is seldom in autologous pericardia canal.It's effective to prevent the brain damage when the intercava or extracava shunt of SVC is employed.

关 键 词：上腔静脉综合征 诊断 手术 

分 类 号：R654.3[医药卫生—外科学]