重症布加综合征的治疗

目的探讨重症布加综合征的介入加手术治疗方法及效果。方法对16例以膜型阻塞为主,阻塞远端下腔静脉,合并肝静脉堵塞的布加综合征患者,实施经皮经腔内支架压栓、球囊扩张成形内支架置入术,术后再次行肠腔分流术。术后随访3个月至8.5 a。结果下腔静脉压力由术前的(2.68±0.40)kPa下降至术后的(1.12±0.21)kPa,上腔静脉压力由术前的(0.40±0.15)kPa上升至(0.87±0.26)kPa,术后与术前比较差别有统计学意义(P<0.05),手术后门静脉压力平均下降(2.27±0.36)kPa。术后无肺栓塞等严重并发症发生。结论对血栓性膜型阻塞性合并肝静脉堵塞型布加综合征,可施行多支架压栓加肠腔分流术治疗。

Treatment of severe type of Budd-Chiari syndrome

Objective To investigate the effect of interventional radiology and surgery treatments for Budd-Chiari syndrome. Methods Sixteen patients with Budd-Chiari syndrome due to thrombus membrane obstruction were performed with multiple stent prssing thrombus, percutaneous balloon dilatation of inferior vena cava and stentt placement for inferior vena cave （IVC） and mesocaval shunt. All patients were followed-up for 3 months to 8.5 years. Results After operation, the pressure of IVC descended from （2.68 ± . 40） kPa to （ 1.12 ±0. 21 ） kPa, and the pressure of superior vena caval pressure rose from （ 0. 40 ± 0.15 ） kPa to （0.87 ±0. 26） kPa, there was statistical significance between pretreatment and posttreatment （ P 〈 0. 05 ）. The portal venous pressure descended （2. 27 ±0. 36 ） kPa posttreatment. There was no severe complication after surgery treatment. Conclusion It is feasible that using multiple stent pressing thrombus and mesocaval shunt to treat the patients with Budd-Chiari syndrome due to thrombus membrane obstruction and hepatic vein obstruction.