布-加综合征人工血管转流术后吻合口狭窄再处理分析  

Retreatment of anastomotic stenosis after artificial vascular bypass in Budd-Chiari syndrome

作　　者：侯国峰 卞策 郭巍 李蓉 朱广昌 Hou Guofeng;Bian Ce;Guo Wei;Li Rong;Zhu Guangchang(Department of Vascular Surgery,Hebei Yanda Hospital,Langfang 065201,Hebei,China;Department of Heart Vascular Surgery,Rocket Force Characteristic Medical Center,Beijing 100088,China)

机构地区：[1]河北燕达医院血管外科,河北廊坊065201 [2]火箭军特色医学中心血管外科,北京100088

出　　处：《血管与腔内血管外科杂志》2022年第5期532-536,M0002,共6页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨布-加综合征(BCS)人工血管转术后流吻合口狭窄再处理情况。方法收集2016—2020年火箭军特色医学中心收治的9例BCS患者的临床资料,根据治疗方法的不同将其分为介入组(n=6)和手术组(n=3)。介入组中5例行单纯经皮血管腔内成型术(PTA),1例溶栓后行PTA球囊扩张肠系膜吻合口。手术组开腹行肠系膜吻合口增生内膜剥脱血管重建。观察比较两组患者的术后腹围、血浆白蛋白、门静脉压力变化情况。结果两组患者门静脉压力、腹围、白蛋白比较,差异均无统计学意义(P>0.05)。术后随访,介入组患者肝功能好转4例,手术组患者肝功能好转2例。结论BCS人工血管转流远期吻合口狭窄较为常见,在充分评估吻合口及分流道情况下选择合适的治疗方式,介入球囊扩张和开放手术吻合口重建远期效果无明显差异。Objective To investigate the retreatment of anastomotic stenosis after artificial vascular bypass in Budd-Chiari syndrome(BCS).Method The Clinical data of 9 patients with BCS admitted to Rocket Force Characteristic Medical Center from 2016 to 2020 were collected and divided into interventional group(n=6)and operation group(n=3)according to different treatment methods.In the interventional group,5 cases underwent simple percutaneous transluminal angioplasty(PTA),and 1 case underwent PTA balloon dilatation of mesenteric anastomosis after thrombolysis.In the operation group,the mesentery anastomosis was opened and vascular reconstruction was performed.The changes of abdominal circumference,plasma albumin and portal vein pressure were observed and compared between the two groups.Result There were no significant differences in portal vein pressure,abdominal circumference and albumin between two groups(P>0.05).During the follow-up,the liver function improved in 4 cases in the intervention group and 2 cases in the operation group.Conclusion Long-term anastomotic stenosis intimal hyperplasia is inevitable after BCS.There is no significant difference in long-term effect between interventional balloon dilation and open surgical anastomotic reconstruction as long as appropriate treatment is selected under the condition of full evaluation of anastomosis and shunt.

关 键 词：布-加综合征 人工血管转流术 肠系膜上静脉 球囊扩张 腹腔积液 

分 类 号：R543[医药卫生—心血管疾病]