Budd—Chiari综合征直视下根治术式的探讨

目的：探讨布－加综合征三种根治性手术的优缺点及适应证。方法：统计直视下ＢＣＳ根治术的４２例资料。隔膜切除或病变的下腔静脉段切开，心包片扩大成形１７例；闭塞或狭窄的下腔静脉段切除，人工血管原位移植２３例；肝静脉流出道成形，同时行肝静脉至右心房的下腔静脉入口处人工血管间置移植２例。结果：因术后并发症死亡２例。复发４例，均为心包片扩大成形术者。

Radical operation under direct vision for Budd Chiari syndrome

Objective:To evaluate the advantage and disadvantage of 3 radical operations under direct vision and their indication for Budd Chiari syndrome(BCS).Methods:42 patients with BCS were operated under direct vision with 3 different methods:membranectomy and pericardial patch cavoplasty in 17 cases,nesection of IVC with occlusion or stricture and artifical blood vessel graft in 23 cases,hepatic venous plasty,and artificial blood vessel graft from hepatic venous to IVC's inlet of right atrium in 2 cases.Results:Two patients died during hospitalization,four patients relapsed in follow up study.The graft with artificial blood vessels is better than pericardial patch cavoplasty.Conclusions:The membranectomy and pericardial patch cavoplasty is indicated for membranous obstruction;resection of IVC and artificial vessel graft for short segmental obstruction;hepatic venous plasty for long segment obstruction of IVC.