5例透析或导线相关性中心静脉梗阻的外科治疗  

Surgical treatment of dialysis or lead related central venous obstruction:a report of 5 cases

作　　者：闵心平 徐鹏[1] 昌金星 王志维[1] 夏军[1] Min Xinping;Xu Peng;Chang Jinxing;Wang Zhiwei;Xia Jun(Department of Cardiovascular Surgery,People’s Hospital Affiliated to Wuhan University,Wuhan 430061,China)

机构地区：[1]武汉大学人民医院心血管外科,武汉430061

出　　处：《中国血管外科杂志（电子版）》2021年第2期135-139,共5页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨应用心包补片、人工血管转流等外科方法治疗透析或起搏导线相关性中心静脉梗阻的效果。方法回顾性分析2016年6月至2020年10月武汉大学人民医院收治的5例腔静脉梗阻患者资料,其中维持性血透合并锁骨下静脉或无名静脉梗阻患者4例,起搏导线植入后合并上下腔静脉梗阻1例。结果围术期无患者死亡,术后肢体肿胀等静脉回流梗阻症状均改善明显,人工血管或心包成形血管无血栓发生,透析患者透析通路功能良好。结论对于腔内治疗效果不佳的透析或起搏导线相关性中心静脉梗阻病变,可考虑应用心包补片、人工血管转流等外科方法治疗。Objective To explore the effect of surgical treatment such as pericardial patch angioplasty and artificial vascular bypass for dialysis or pacing lead related central venous obstruction.Methods The clinical data of 5 patients with vena cava stenosis or occlusion treated in People’s Hospital Affiliated to Wuhan University from June 2016 to October 2020 were analyzed retrospectively,including 4 patients with maintenance hemodialysis combined with subclavian vein stenosis or innominate vein stenosis,and 1 patient with superior and inferior vena cava obstruction after pacemaker wire implantation.Results There was no death during the perioperative period.The clinical symptoms such as limb edema improved significantly,and no thrombosis occurred after the operation.The dialysis access function of the dialysis patients was satisfying.Conclusion Pericardial patch angioplasty and artificial vascular bypass can be used for the treatment of dialysis or pacing lead related central venous obstruction.

关 键 词：中心静脉梗阻 透析 起搏导线 心包血管成形 人工血管旁路 

分 类 号：R654.4[医药卫生—外科学]