布加综合征的手术治疗及预后分析  

Analysis of Operation and Prognosis of Budd-Chiari Syndrome

作　　者：孟庆义[1] 王瑞华[1] 刘兆轩[1] 李博[1] 张俊宇[1] 吴鼎[1] 

机构地区：[1]山东大学附属济南市中心医院血管外科,山东济南250013

出　　处：《中国普外基础与临床杂志》2014年第12期1482-1486,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：山东省自然科学基金(项目编号:ZR2009CM052);济南市科技局基金(项目编号:201401079);济南市卫生局基金(项目编号:2008-11)~~

摘　　要：目的总结布加综合征手术治疗的基本术式及治疗效果。方法回顾性分析笔者所在医院1994年4月至2013年12月期间收治的1 024例布加综合征患者的临床资料,总结布加综合征手术治疗的基本术式及治疗效果。结果 1 024例患者中,行外科手术116例,行介入手术908例;行下腔静脉单纯球囊扩张术265例,行下腔静脉球囊扩张加支架置入术464例,行肝静脉开通术97例,行经右心房-股静脉联合破膜球囊扩张支架成形术52例,行肠-腔静脉分流术7例,行根治性矫正术20例,行下腔静脉-右心房人工血管转流术45例,行腔-肠-房联合转流术6例,行腔-肠-颈联合转流术9例,行经颈静脉肝内门-体分流术30例,行肠-房转流术29例。术后获访902例,随访时间为1 d^19年,平均13年。严格、灵活地应用各种术式治疗布加综合征为患者带来了令人满意的效果。结论布加综合征由多种原因所引起,其治疗应当根据不同的病因或病理类型而选择不同的治疗方法;对布加综合征的诊断与分型有助于我们制定安全、合理及有效的治疗方案。Objective To investigate the basic operation and treatment experiences of the surgical treatment of Budd-Chiari syndrome （BCS）. Methods Clinical data of 1024 cases of BCS who received surgical treatment in our hospital from April 1994 to December 2013 were collected and analyzed. Results There were 1024 cases in our study, 116 cases of them underwent surgery, 908 cases of them underwent interventional surgery; 265 cases underwent inferior vena cava （IVC） balloon dilatation, 464 cases underwent IVC balloon dilatation and stenting, 97 cases underwent open surgery of hepatic vein （HV）, 52 cases underwent right atrium femoral vein combined membrane rupture balloon dilation stent, 7 cases underwent caval shunt, 20 cases underwent radical surgery, 45 cases underwent IVC-right atrium bypass, 6 cases underwent intestinal cavity-real shunt, 9 cases underwent intestinal cavity-neck combined shunt, 30 cases underwent transjugular intrahepatic portosystemic shunt, 29 cases underwent intestinal-line real shunt. There were 902 cases were followed-up for 1 day-19 years （13 years on average）, and the application of many kinds of operation strictly and flexibly brought satisfactory results for cases of BCS. Conclusions The diagnosis and classification of BCS will help us to make safe, effective, and appropriate treatment plan. In addition, we must use color Doppler ultrasound to observe the pathological changes of the situation, in this way we can have a clear goal in the treatment process.

关 键 词：布加综合征 外科手术 介入治疗 肝静脉 下腔静脉 

分 类 号：R657.3[医药卫生—外科学]