摘要
目的 探讨复发性布 -加综合征的治疗方法。方法 常温非体外循环下阻断梗阻上、下端的下腔静脉 ,切开梗阻部位 ,取出血栓 ,矫正畸形 ,用自体心包补片成形下腔静脉。结果 3 9例术后均肝脾肿大缩小 ,腹水消失或减少 ,下腔静脉压力降低 6～ 11cmH2 O。B超检查显示 :全部病人术后原下腔静脉狭窄处直径 3 .5cm ,血流通畅。术后 7例出现短暂血尿 ,5例出现心功能不全 ,其中 2例出现胸水 ,无 1例住院死亡。随访 3个月～ 6年 ,3例术后 1年内死于多器官功能衰竭 ,1例死于肺部疾病 ,2例术后 2年死于其他非相关疾病。 4例失访。 2 9例恢复正常生活 ,无复发肝脾大、腹水。结论 常温非体外循环下腔静脉成形治疗复发性布
Objective To explore the treatment of relapsing Budd Chiari syndrome(BCS). Methods Inferior vena cava(IVC) was stemmed on the two sides of the obstruction at normothermia without extracorporeal circulation. Then, the obstructed IVC was opened, the thrombus was taken out, the malformation was corrected, and the IVC was reconstructed by autogenous pericardial patch. Results In all the thirty nine cases, hepatosplenomegaly was shrunk, ascites decreased or disappeared, and the IVC pressure was reduced to 6～11 cmH 2O after the operation. Ultrasonic examination showed that the diameter at obstruction site was enlarged to more than 3～5cm postoperatively in all cases. Temporal hematuria occurred in 7 cases;cardiac function insufficiency was found in 5, of which 2 developed hydrothorax after the operation. There was no in hospital death in this series. With for 3 months to 6 years follow up, 3 patients died of multiorganic failure 1 year postoperatively, one died of pulmonary disease, 2 died of unrelated diseases 2 years after the operation, 4 were lost, and the other 29 returned to normal life without relapse of hepatosplenomegly and ascites. Conclusions IVC reconstruction under normothermia without extracorporeal circulation is an ideal treatment for relapsing Budd chiari syndrome.
出处
《中国普通外科杂志》
CAS
CSCD
2002年第7期399-401,共3页
China Journal of General Surgery
