放射介入加肠腔架桥联合门奇断流术治疗布-加综合征  

Interventional therapy plus mesocaval C-graft shunt and portal azygous devascularization for Budd-Chiari syndrome.

作　　者：冯留顺[1] 马秀现[1] 许培钦[1] 

机构地区：[1]河南医科大学第一附属医院普外科,郑州450052

出　　处：《中国实用外科杂志》2000年第10期618-619,共2页Chinese Journal of Practical Surgery

摘　　要：目的　评价下腔静脉放射介入加肠腔C型架桥联合门奇断流术对布 -加综合征的治疗效果。方法　对 1995年 7月至 1998年 12月收治的 10例下腔静脉及主肝静脉完全闭塞、又无扩张代偿的副肝静脉的10例病人 ,行经皮腔下腔静脉球囊导管扩张内支架术后 ,再行肠系膜上静脉下腔静脉人工血管C型架桥联合门奇断流术 (联合手术 )。结果　下腔静脉压力由 1 5 7～ 2 7kPa(16～ 2 8cmH2 O )降至 0 78～ 1 47kPa(8～15cmH2 O) ,门静脉压力由 2 94～ 4 41kPa(30～ 45cmH2 O)降至 2 45～ 2 94kPa(2 5～ 30cmH2 O) ,1例病人死于手术后急性肝功能衰竭 ,余随访 6个月至 2年 ,肝脾缩小 ,腹水减少或消失 ,下肢水肿消失。结论　本联合术式对某些类型的布 -加综合征病人为合理。Objective To evaluate the effect of interventional treatment (balloon dilation and endovascular stents placement)of inferior vena cava (IVC)plus mesocaval C-graft(M-C C)shunt and portal azygous devascularization (combined operation)for Budd-Chiari syndrome (BCS).Methods 10 patients with obstruction of IVC and main hepatic veins (MHVs)and without any compensatory dilation of associated hepatic veins(AHVs) underwent the combined operation from July 1995 to December 1998 in our hospital.Results The IVC pressure declined from 16～28cmH 2O to 8～15 cmH 2O,and the portal venous pressure declined from 30～45cmH 2O to 25～30cmH 2O in the patients who underwent the combined procedure,one died of postoperative acute hepatic failure,and the others were still alive without hepatosplenomegaly,ascites or edema of lower extremities during the follow-up period of 6～24 months.Conclusion The combined procedure is rational and practical for some pathological types of BCS.

关 键 词：肠腔静脉分流术 门奇断流术 布-加综合征 

分 类 号：R657.340.5[医药卫生—外科学]