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目的 探讨膜性BuddChiari综合症(BCS)的治疗方法,评价放射介入和根治性病变隔膜切除术对膜性BCS的治疗效果。方法 对1990年5月～1997年12月我院收治的342例膜性BCS病人的临床资料进行回顾性分析。结果 手术治疗182例(其中18例为介入治疗失败者),采用常温直视下病变隔膜切除;介入178例,采用经皮腔下腔静脉球囊扩张成形术(PTA)156例,经皮腔下腔静脉球囊扩张成形术及经皮肝肝静脉扩张成形术22例,其中10例加用血管内支架(Stent)放置。手术组随访177例中总有效率898%,复发率102%;介入组总有效率810%,死亡率17%(3例),复发率190%,介入失败112%。结论 大部分膜性BCS病人经PTA或PTA加血管内支架治疗可取得良好效果,对介入治疗失败者、下腔静脉内有血栓者、介入治疗后复发者或下腔静脉内为斜或厚膜的病人应选择根治性膜切除术。
Objective To investigate the treatment of membranous Buddhi syndrome (BCS) and evaluate the effect of radiofrequency ablation and radical resection on membranous BCS. Methods The clinical data of 342 cases of BCS patients admitted to our hospital from May 1990 to December 1997 were analyzed retrospectively. Results 182 cases of surgical treatment (including 18 cases of failure of interventional treatment), the use of room temperature under direct vision diaphragm resection; interventional 178 cases, using percutaneous transluminal ventricular balloon angioplasty (PTA) 156 cases of percutaneous cavity Inferior vena cava balloon angioplasty and percutaneous transhepatic hepatic vein expansion in 22 cases, of which 10 cases plus stent placement (Stent). In the operation group, the total effective rate was 898% and the recurrence rate was 102%. The total effective rate was 810% and the mortality rate was 17% (3 cases) in the intervention group. The recurrence rate was 190% and the failure rate was 112%. Conclusion Most of membranous BCS patients can be treated with PTA or PTA plus endovascular stent. Good results can be achieved in patients with unsuccessful interventional therapy, thrombosis in inferior vena cava, recurrent or inferior vena cava after interventional therapy Of patients should choose radical resection.