布-加综合征下腔静脉阻塞合并血栓形成的治疗

目的 探讨下腔静脉阻塞并血栓形成的布-加综合征的治疗方法.方法 回顾分析近6年间收治的75例下腔静脉阻塞并血栓形成的布一加综合征患者的临床资料.其中行根治性隔膜切除、血栓取出22例,腔-腔(房)人工血管架桥41例,放射介入+内支架放置12例.结果 73例手术成功,手术死亡2例,手术后下腔静脉压力明显下降.临床症状及体征消失或缓解.随访6个月至6年,复发4例;其中人造血管堵塞2例,再发下腔静脉狭窄2例.结论 对下腔静脉阻塞合并血栓形成的布一加综合征患者,根据阻塞节段及血栓长度选择相应手术方式,大多可以取得满意效果.

The treatment of Budd-chiari syndrome with inferior vena cava thrombosis

Objective:To evaluate the treatment of Budd-chiari syndrome (BCS) with inferior vena cava (IVC) thrombosis.Methods :The clinical data of 75 cases of BCS with inferior vena cava thrombosis were retrospectively analysed.Among them, 22 cases underwent radical resection of lesion and thrombns extraction; 41 cases had cavocaval shunt or cavoatrial shunt; 12 patients had percutaneous transluminal angioplasty (PTA) and endoluminal metallic stent (EMS) placement. Results:Successful operations were performed in 73 patients and 2 patients died. The vena cava pressure decreased narkedly after treatment. Seventy-three patients were followed-up from 6 months to 6 years, 4 patients had recurrence, of which 2 had artificial blood vessel obstruction, and 2 had restenosis of IVC. Conclusions:The operative method selected for BCS with inferior vena cava thrombosis should be based on the segment of obstruction and the length of thrombosis, and the majority of patients can have a favorable outcome.