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下腔静脉畸形的症状学与治疗(作者译)

[Symptomatology and treatment of malformations of the inferior vena cava (author's transl)].

作者信息

Sachweh D, Horsch S, Janssen W

出版信息

Langenbecks Arch Chir. 1979 May 2;348(2):119-32. doi: 10.1007/BF01239669.

Abstract

A review of the embryology, pathophysiology semiotics and surgical treatment of malformations of the inferior vena cava is given based on 3 clinical histories. The cases consisted of a typical membrane occlusion, an atresia of the infrarenal segment and of a hitherto not described combination of several malformations of the inferior vena cava: membrane occlusion, aplasia of the infrarenal segment of the vena cava inferior and multiple aneurysms of the iliac vein. The symptomatology of malformations of the vena cava inferior depends on the compensation by the collateral or the persisting embryonic veins, respectively, and on the localization and the degree of the obliteration. The varying hemodynamic reactions are described. The following surgical methods for the treatment of inferior vena cava occlusions in the hepatic segment are available: The so called conservative interventions for the creation of collaterals, the direct or indirect recanalization and the bypass operation. Congenital infrarenal atresias of the vena cava are corrected by homologous or prosthetic interposition. The venous replacement with a bovine heterograft presented here, has not yet been described in the literature.

摘要

基于3例临床病例,对下腔静脉畸形的胚胎学、病理生理学、症状学及外科治疗进行了综述。这些病例包括典型的膜性闭塞、肾下段闭锁以及一种此前未描述过的下腔静脉多种畸形的组合:膜性闭塞、下腔静脉肾下段发育不全及髂静脉多发动脉瘤。下腔静脉畸形的症状取决于侧支循环或持续存在的胚胎静脉的代偿情况,以及闭塞的部位和程度。文中描述了不同的血流动力学反应。治疗肝段下腔静脉闭塞的手术方法如下:所谓的建立侧支循环的保守干预、直接或间接再通以及旁路手术。先天性肾下段下腔静脉闭锁通过同种异体或人工血管置换进行矫正。本文介绍的用牛异种移植物进行静脉置换,在文献中尚未见报道。

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