Budd－Chiari综合征直视根治术

自１９８６年１月至１９９３年４月作者在常温血管阻断下经右胸腔切开下腔静脉直视根治Ｂｕｄｄ－Ｃｈｉａｒｉ综合征６７例，其中膜切除３７例次、血栓或癌栓摘除１９例次、心包片腔静脉扩大成形２８例次、心包片成管代血管移植３例和解除外压３例。手术死亡３例，２例死于出血性休克，１例死于右心衰。其他６４例治愈出院。术后随访５～８４个月者６４例，６１例典型表现均消失。Ｂ超和下腔静脉造影证实肝静脉和下腔静脉开放通畅者６１例，显示下腔静脉狭窄２例和下腔静脉血栓形成１例，取得了良好疗效。

A radical operation under direct vision for the Budd-Chiari syndrome

From January 1986 to April 1993, 67 patients with Budd-Chiari syndrome underwent radical operation under direct vision in room temperature through right thoracic cavotomy by blocking the infrahepatic inferior vena cava (IVC) and the IVC was opened. Transcaval membranectomy was successfully performed. in 37 patients. Removal of thrombosis and cancer embolus in 19 cases, pericardial patch cavoplasty in 28 cases, vasotransplantation of pericardial canal made of pericardial patch in 3 cases, and lysis of extracaval compression in 3 cases. The operative mortality rate was 4. 48% (3 cases),two cases died of operative hemorrhagic shock and one died of postoperative right heart failure. The other 64 patients (95. 5%) were discharged,and were all in good condition found by a follow-up of 5 to 84 months. B-mode ultrasonography showed good patency of the IVC and hepatic veins (HV) in 60 cases, and stenosis of the IVC in 2 cases, and membranous obstruction of left hepatic vein in one.