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机构地区:[1]临沂市人民医院,临沂276003 [2]郯城县中医医院
出 处:《临沂医学专科学校学报》1998年第1期37-40,共4页Journal of Linyi Medical College
摘 要:本文对60例布-加氏综合征病人的手术并发症进行了分析。方法在全麻下经右心房下腔静脉破膜16例,下腔静脉右心房人造血管转流29例,联合转流4例,脾肺固定加门奇静脉断流4例,直视下下静脉、肝静脉隔膜切除7例。结果木后10d内出现急性心功能衰竭10例,急性肾功能衰竭、肺动脉栓塞各1例,1年后继发血栓形成14例,肝昏迷5例,随访4月~7年,症状、体征消退29例,症状、体征减轻18例,无效7例,围手术期死亡3例,1年后死亡3例。结论布-加氏综合征手术治疗效果好,但并发症多,如做好围手术期处理及术后坚持正规抗凝治疗,可减少手术并发症的发生,提高手术疗效。Objective The results of operative complications of 60 cases of Budd chiari syndrome were analysed in this paper. Methods 16 cases were treated with ruptureof membranes of inferior vena cava through right atrium under general anesthesia, 29cases with right atrium artificial vascular shunt of inferior vena cava, 4 cases with combined shunt, 4 cases with spleen-- lung fixation and portaazygous devascularization and 7cases with diaphragm excision of inferior vena cava and venae hepaticae under direct vision. Results There were 10 cases of acute cardiac functional failure, 1 case of acute renalfailure and I case of pulmonary embolism which occurred 10 days after opertion. Andthere were 14 cases of secondary thrombosis and 5 cases of coma hepaticum occurringone year later. A follow-- up survey of 4 months to 7 years showed that there were 29cases whose symptoms and signs had disappeared, 18 cases whose symptoms and signshad lightened and 7 cases with no curative effect. 3 cases died during the period roundthe operation and 3 cases died one year later. Conclusion Budd --chiari syndrome has agood operative effect except for some complications. If the period round the operationwas well managed and regular anticoagulant therapy of post--operation were upheld,theoccurrence of operative complicatios could be reduced, thus increasing the therapeutic effectiveness.
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