Maamies T, Luosto R, Ketonen P, Ketonen L
Scand J Thorac Cardiovasc Surg. 1982;16(3):259-61. doi: 10.3109/14017438209101059.
The syndrome caused by the acute obstruction of the superior vena cava with central nervous system symptoms as well as with symptoms related to the oedema of the upper respiratory tract is often very severe and fatal to the patient. Conservative treatment is usually of no help, and consequently the palliative reconstruction of the superior vena cava may be indicated. Two cases of acute superior vena caval syndrome with reconstruction of the superior vena cava are presented. In the first case, when a malignant mediastinal tumour (Hodgkin's) was removed, a segment of the superior vena cava and the anonymous vein had to be removed. Following this operation acute superior vena caval syndrome developed and another operation was performed in which the superior vena cava was reconstructed with a Dacron prosthesis. Radiological examination of the superior vena cava 28 months postoperatively showed the prosthesis patent and the patient was free from symptoms. 51 months after the operation the patient was still asymptomatic. In the second case the obstruction of the superior vena cava was caused by anaplastic carcinoma of the upper lobe of the right lung. The acutely obstructed superior vena cava was reconstructed with a Dacron prosthesis. 9 months postoperatively the superior vena caval syndrome recurred and two months later the patient died of lung cancer. In both cases good palliation of the obstruction of the superior vena cava was obtained.
上腔静脉急性梗阻所致综合征，伴有中枢神经系统症状以及上呼吸道水肿相关症状，通常病情极为严重，对患者可致命。保守治疗往往无效，因此可能需要对上腔静脉进行姑息性重建。本文介绍了两例上腔静脉急性综合征并进行上腔静脉重建的病例。第一例，在切除恶性纵隔肿瘤（霍奇金淋巴瘤）时，不得不切除一段上腔静脉和无名静脉。该手术后发生了急性上腔静脉综合征，遂再次手术，用涤纶人工血管重建上腔静脉。术后28个月对上腔静脉进行放射学检查显示人工血管通畅，患者无症状。术后51个月患者仍无症状。第二例，上腔静脉梗阻由右肺上叶间变性癌引起。对上腔静脉急性梗阻用涤纶人工血管进行重建。术后9个月上腔静脉综合征复发，两个月后患者死于肺癌。两例均对上腔静脉梗阻取得了良好的姑息治疗效果。
