Budd-Chiari综合征与直视根治术

Budd-Chiari综合征行直视根治术观察其病变并作分析。方法:在常温下血管阻断或置管转流下,经右胸作下腔静脉(IVC)切开行膜切除、血栓摘除、癌栓摘除、自体心包片腔静脉成形、心包管代血管移植等手术共70例。结果:手术死亡3例,术后67例随访5～84个月(平均45个月),B超和IVC造影显示IVC-HV通畅者64例,术后4个月IVC血栓形成1例,术后1～1.5年示IVC狭窄2例。结论:Budd-Chiari综合征用直视根治术是一种较理想的疗法。

Clinical Study of Budd-Chiari Syndrome and Radical Operation under Direct Vision.

Background/Aims: To study the Budd-Chiari syndrome(BCS) treated by radical operation under direct vision(RODV). Methods: 70 patients underwent RODV in room temperature, through right cavotomy, excision of memberanous substance, extirpation of thrombus or cancer embolus, autologus pericardial patch cavoplasty, autologus pericardial conduit transplantation, removal of fibrinous band or tumor were carried out according to the type of lesion present; associated lesions of the hepatic vein were also corrected in 40 cases. Results: Operative death occured in 3 cases, with a mortality of 4.3%, 2 died of hemorragic shock and 1 died of right heart failure. The other 67 patients were follow-up 5~84 months(mean 45 months) after discharge. Ultrasonography and cavography showed patency of the inferior vena cava(IVC) and hepatic vein(HV) in 64 cases, thrombosis of the grafted pericardial conduit 1 case and stricture of the IVC in the other 2 cases. Conclusions: It is believed that correction of existing defomity under direct vision by the method reported here in could provide immediate and long-term benefit for patients suffering from BCS.