布加综合征的房间隔分流术

Mesoatrial Shunt for Budd-Chiari Syndrome.

作者信息

Zhu Guang-Chang, Wang Zhong-Gao, Bian Ce, Zhang Jian-Wei, Hu Zhi-Wei, Hou Guo-Feng, Guo Wei, Ma Chao

机构信息

Department of Cardiovascular Surgery, The General Hospital of the PLA Rocket Force, Beijing Normal University, Beijing, China.

Department of Cardiovascular Surgery, The General Hospital of the PLA Rocket Force, Beijing Normal University, Beijing, China; Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Vasc Surg. 2018 Feb;47:62-68. doi: 10.1016/j.avsg.2017.07.020. Epub 2017 Jul 21.

DOI:10.1016/j.avsg.2017.07.020

PMID:28739463

Abstract

BACKGROUND

The long-term efficacy of mesoatrial shunt (MAS) for Budd-Chiari syndrome (BCS) is not well studied. The purpose of our study was to investigate the long-term outcome and efficacy of MAS for BCS.

METHODS

We retrospectively evaluated 11 patients who underwent MAS for BCS from April 1986 to November 1995. Records of patients' clinical presentations, laboratorial investigation, Doppler duplex ultrasonography, radiologic image, and treatment outcomes were all retrieved and analyzed.

RESULTS

Follow-up intervals ranged from 1 year and 2 months to 30 years and 2 months (mean, 17 years and 8 months). Portal pressure decreased significantly from 35.72 ± 3.52 cm HO to 27.86 ± 5.83 cm HO post-MAS (P = 0.001). The 5-year, 10-year, and 20-year patency were 72.7%, 54.5%, 36.4%, respectively; 63.3% of patients had survived for more than 10 years and 45.5% for more than 20 years. A male has been alive with patent shunt for 28 years and 1 month.

CONCLUSIONS

The MAS with enforced rings is an effective therapeutic modality for BCS with cautious perioperative management.

摘要

背景

中房分流术（MAS）治疗布加综合征（BCS）的长期疗效尚未得到充分研究。我们研究的目的是调查MAS治疗BCS的长期结局和疗效。

方法

我们回顾性评估了1986年4月至1995年11月期间接受MAS治疗BCS的11例患者。检索并分析了患者的临床表现、实验室检查、多普勒双功超声、影像学图像及治疗结局记录。

结果

随访时间为1年2个月至30年2个月（平均17年8个月）。MAS术后门静脉压力从35.72±3.52cmH₂O显著降至27.86±5.83cmH₂O（P = 0.001）。5年、10年和20年的分流通畅率分别为72.7%、54.5%、36.4%；63.3%的患者存活超过10年，45.5%的患者存活超过20年。一名男性患者分流通畅存活了28年1个月。