摘要
目的探讨改良脾-肺固定术治疗布-加综合征（B—CS）的效果。方法回顾分析126例行改良脾-肺固定术B—CS患者的临床资料。结果本组术后并发症发生率为7．94％（10／126），围手术病死率1．60％（2／126）。对86例术后患者进行了随访，平均随访时间（7．8±1．2）（9个月～18年）年。总有效率83．7％（72／86），其中22例经彩色超声检查随访，16例行经皮脾穿刺脾门造影（造影时间为术后1个月至16年），均显示脾-肺间有不同口径和数量不等的侧支循环形成。无效或复发8例（9．30％）。死亡6例（7．00％），其中2例术后第2和第3年因肝性脑病死亡，2例于术后2年内再发上消化道大出血死亡，2例于术后并发肝癌死亡。结论改良脾-肺固定术能有效降低门静脉压力、控制（或预防）食管胃底曲张静脉破裂出血、缓解脾功能亢进。是一种具有一定的临床应用价值和值得推广的手术。
Objective To study the value of modified splenopneumopexy in the treatment of Budd-Chiari syndrome （B-CS）. Methods The clinical data of 126 patients with BCS treated by modified splenopneumopexy were analysed retrospectively. Results In this series, the postoperative complication rate was 7. 94% （112/126）, the perioperative mortality rate was 1.60% （2/126）; and 86 cases were followed up for 9 months to 18 years, the mean time was （ 7.8 ± 1.2 ） years, the effective rate was 83.7 % （72/86）. Among them, 22 patients followed up by color Doppler ultrasound, and 16 patients by percutaneous splenoportography （ 1 month - 6 years after operation ） , which showed the collateral circulation of various diameters and numbers between the spleen and lung was formed. In 8 cases the operation was ineffective or B-CS recurred. Six cases died, two of them died of hepatoencephalopathy 2 and 3 years after operation respectively, two of upper digestive tract rebleeding, and 2 of hepatocellularcarcinoma. Conclusions Splenopneumopexy can decrease portal vein pressure, relieve hypersplenism and ascites, and control （or prevent ） upper digestive tract bleeding. Splenopneumopexy is a valuable and worthy operation for B-CS, and can be widespread application.
出处
《中国普通外科杂志》
CAS
CSCD
2006年第12期884-886,共3页
China Journal of General Surgery
