手术和保守治疗55例布加综合征的临床疗效对比  

Surgery treatment versus conservative treatment for Budd-Chiari syndrome: a report of 55 cases

作　　者：唐前辉[1] 杨晗[1] 胡明[1] 陈靖[1] 覃晓[1] 

机构地区：[1]广西医科大学第一附属医院血管外科,南宁530022

出　　处：《中国血管外科杂志（电子版）》2017年第2期117-122,共6页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：国家自然科学基金项目(8110047);广西医疗卫生重点科研课题(200913)

摘　　要：目的分析对比布加综合征经保守治疗与手术治疗的疗效。方法回顾性分析广西医科大学第一附属医院自2008年1月至2015年10月收治的55例布加综合征患者的临床资料。根据治疗方法不同分成手术治疗组(27例)和保守治疗组(28例),分别对两组的疗效、生存时间及并发症进行随访并对比分析。结果 55例患者失访4例,随访时间1~94个月,随访期间死亡7例(13.7%)。手术治疗组患者5年生存率为95.5%,保守治疗组5年生存率为78.1%,差异有统计学意义(P<0.05)。手术治疗组有3例复发,5年复发率为19.1%,通畅率为80.1%。手术治疗组的门脉高压症状以及乏力、食欲欠佳症状明显缓解,优于保守治疗组,差异有统计学意义(P<0.05)。腹壁静脉曲张、下肢肿胀、下肢静脉曲张、静脉性溃疡、色素沉着、恶心、呕吐等下腔静脉高压症状两组比较差异无统计学意义(P>0.05)。结论布加综合征患者在排除手术禁忌证时,应结合患者病情,及时选择合适的手术方式。Objective To compare the clinical effect between surgery treatment and conservative treatment for Budd-Chiari syndrome. Methods The data of 55 patients with Budd-Chiari syndrome who were treated in the First Affiliated Hospital of Guangxi Medical University from Jan. 2008 to Oct. 2015 was analyzed retrospectively. They were divided into two groups, 27 patients in surgery treatment group and 28 patients in conservative treatment group. Results Four cases were lost during the follow-up. During the follow-up time of 1-94 months, 7(13.7%) cases died. The 5 years survival rate of patients in surgery group was 95.5% while it was 78.1% in conservative group(P< 0.05). There were 3 cases recurrence in surgery group and the recurrence rate of 5 years was 19.1%. The portal hypertension symptoms, fatigue, and anorexia in surgery treatment group were less than conservative treatment group, with statistically difference(P <0.05). However, there was no absolute difference in incidences of varicose vein of abdominal wall, lower limbs edema, varicose vein of lower limbs, venous ulcer, pigmentation, nausea and vomiting symptoms of inferior vena cava(P>0.05).Conclusions The efficacy of surgery treatment effective for Budd-Chiari syndrome is superior than conservative treatment in general. Surgery treatment can improve prognosis obviously as long as patient apply to surgery in time.

关 键 词：布加综合征 手术治疗 保守治疗 疗效 

分 类 号：R575[医药卫生—消化系统]