中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (11): 899-901.

• 专题笔谈 • 上一篇    下一篇

布-加综合征的外科治疗

孙玉岭， 许培钦   

  1. 郑州大学第一附属医院普外科, 郑州 450052
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-11-09 发布日期:2009-11-09

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-11-09 Published:2009-11-09

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摘要：

布-加综合征（BCS）是一种肝后型门静脉高压症，外科手术是主要的治疗手段，根据临床病理学分型选择合理术式是提高其治疗效果的关键；高位肠-腔分流术不但提高了传统肠-腔分流术的手术成功率，而且在控制并发症等方面具有显著优势。BCS合并肝癌的治疗选择应以治疗肝癌为主，延长病人的生存时间。对于部分肝静脉和下腔静脉联合病变的BCS病人，分期治疗可以取得良好疗效。分流术联合保脾断流术在布?加综合征治疗中效果满意。对于部分布?加综合征肝内外侧支代偿完全的病人，应重新认识其治疗适应证。

关键词: 布-加综合征, 门静脉高压

Abstract:

Surgical treatment of Budd-Chiari syndrome SUN Yu-ling, XU Pei-qin. Department of General Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China Corresponding author: SUN Yu-ling, E-mail: ylsun@zzu.edu.cn Abstract Budd-Chiari syndrome (BCS) is a kind of retro-hepatic portal hypertension and surgical procedures are the main methods for its treatment. The choice of surgical procedures according to the clinical pathologic classification is the key for successful management. The new procedure of upper meso-caval shunt possesses higher operative successful rate and takes great advantages in the control of varied complications. The management of BCS complicated with hepatocellular carcinoma (HCC) should focus on HCC which determines the prognosis. Stage treatment will be better choice for subpopulation of BCS with the obstruction of IVC and HVs. Shunt combined with devascularization without splenectomy achieves satisfied results and it should re-evaluate the therapic indication for such BCS patients with complete compensation by intora-and extra-hepatic collateral circulations.

Key words: Budd-Chiari syndrome, portal hypertension