摘要
目的探讨介入治疗布-加综合征(BCS)适应证及其失误后的外科治疗措施。方法回顾性分析21例行下腔静脉放置支架失误的BCS患者临床资料。结果21例失误中适应证选择不当6例,支架堵塞主肝静脉1例,堵塞扩张的副肝静脉10例,支架移位3例,支架未展开1例。19例改行手术治疗,其中18例行分流术,1例行下腔静脉隔膜根治性切除术。手术治疗的19例均获成功。18例分流术后自由门静脉压力(FPP)明显下降(P<0.05),无围手术期死亡。随访15例,随访时间为6个月至6年。有效率86.7%(13/15),复发率6.7%(1/15)。1例患者于术后2年死于肝性脑病。结论介入治疗BCS时要严格掌握其适应证,对介入治疗失误和复发病例可选用不同的分流手术。
Objective To investigate the indications for interventional therapy of Budd-Chiari syndrome((B-CS)) and surgical treatment after stent failure. Methods A retrospective analysis of the clinical data of 21 patients with mistakes in treatment of B-CS by stent placement in inferior vena cava(IVC).Results (Among) the 21 cases with mistakes, the indications were inappropriately selected in 6 cases, the main hepatic vein was obstructed by the stent in 1 case, dilated accessory veins were occluded in 10 cases, the stent was (displaced) in 3 cases, and the stent failed to unfold in 1 case. Nineteen cases were converted to operation; of these patients, a shunt was performed in 18 cases, and radical excision of diaphragmatic web of IVC was done in 1 case. Operation was successful in all 19 cases. After shunt procedure in the 18 cases, the free portal pressure significantly decreased(P<0.05); no patient died perioperatively. 15 cases were followed up for 6 months to 6 years. The effective rate was 86.7%(13/15), recurrence rate was 6.7%(1/15), and 1 case died of hepatic encephalopathy. Conclusions Indication for interventional therapy for (B-CS) should be stricv.Various types of shunt can be selected for cases of mistakes or recurrences related to (interventional) therapy.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第6期410-412,共3页
China Journal of General Surgery
