体外循环下治疗布-加综合征合并下腔静脉血栓形成(附49例病例报告)

目的总结在体外循环辅助下,经右房切口治疗合并下腔静脉血栓形成的布-加氏综合征的治疗经验。方法回顾我院自2002年9月至2010年7月共计49例在体外循环辅助下,经右心房切口治疗合并下腔静脉血栓的布加氏综合征的临床病例和随访资料。结果全组病人均成功的在体外循环辅助下完成经右房切口下腔静脉狭窄段扩张及血栓取出术。术中在手指破膜后再使用3.0×4.0cm球囊进行扩张。围手术期病人无死亡,无急性肺栓塞等严重并发症的发生。术后随访0～36个月,所有病人术后症状明显缓解,腹水及下肢水肿减轻至消失。1例病人术后1年后出现再狭窄,经股静脉行下腔静脉球囊扩张后好转。全组病人术后随访未见有血栓形成。结论在体外循环下,经右房切口对于合并下腔静脉血栓的布-加氏综合征是一种安全有效的治疗方法。

Surgery for Budd-Chiari Syndrome with Inferior Vena Cava Thrombosis under Cardiopulmonary Bypass Treatment(Clinical Report of 49 Cases)

Objective To summarize the experience of surgery for Budd-Chiari syndrom with inferior vena cava thrombosis through right atrial incision under cardiopulmonary bypass.Methods The clinical data of 49 Budd-Chiari syndrom combined with inferior vena cava thrombosis patients treated with right atrial incision under cardiopulmonary bypass in our hospital from September 2002 to July 2010 were analysed retrospectively.Results All patients were successfully treated in stenosed vena cava dilation and thrombectomy through right atrial incision under cardiopulmonary bypass.3.0×4.0 cm balloon was used to reexpand after finger film breaking intraoperation.No death or serious complications such as acute pulmonary embolism were found peri-operatively.The follow-up study continued from 0 to 36 months postoperation and the symptoms in all patients were obviously alleviated.Re-stenosis appeared in 1 cases and symptom improved after inferior venacava ball bag expansion.There was no thrombopoiesis after follow-up.Conclusion Right atrial incision under cardiopulmonary bypass is safe and effective in the treatment of Budd-Chiari syndrom with inferior vena cava thrombosis.