重症布-加综合征外科治疗174例的临床分析

目的 探讨目前重症布-加综合征合理的治疗方案.方法 对我院收治的重症布-加综合征174例患者的临床资料做一回顾性分析.放射介入治疗12例,均行经皮肝穿肝静脉球囊导管扩张成形术,成形后内支架置入5例;手术治疗148例,其中肠-腔分流术 93例,脾-腔分流术 5例,脾-颈内静脉转流术48例,肠-颈内静脉转流术2例;介入加分流联合手术治疗14例,均采用Seldinger技术行下腔静脉球囊导管扩张成形和内支架置入后再行肠-腔分流术.结果 围手术期死亡9例(死亡率5.17%),随访160例(随访率96 .97%),随访时间3月～8年,有效例数156例(有效率96.88%),远期死亡2例(死亡率1.25%).结论 重症布-加综合征治疗方式的选择应根据病变类型进行.

Surgical treatment of severe Budd-Chiari syndrome:a review of 174 cases

Objective To discuss the current reasonable solution to the treatment of severe Budd-Chiari syndrome.Methods Medical records of 174 patients with severe Budd-Chiari syndrome admitted to our hospital were retrospectively analyzed. Percutaneous hepatic vein angioplasty was applied to 12 cases, with metallic stent placement in 5 cases; mesocaval shunt was performed in 93 cases, splenocaval shunt in 5 cases; splenojugular shunt in 48 cases, mesojugular shunt in 2 cases; mesocaval shunt after percutaneous intraluminal angioplasty with metallic stent placement in the inferior vena cava was achieved in 14 cases.Results 9 cases died in perioperation . 160 cases were followed up from 3 weeks to 8 years with efficient rate of 96.88%, long-term death rate 1.25%.Conclusion Management options should be on the basis of pathological changes in severe Budd-Chiari syndrome .