【摘要】 下腔静脉肝段膜性梗阻是一种罕见的临床病征。多数病人在下腔静脉肝段有一定长度的阻塞。最后诊断须藉腔静脉造影才能确定,下腔静脉膜性梗阻有时并发肝静脉阻塞,在外科处理上存在很多问题。各种旨在把门脉血流引入下腔静脉的门体分流术显然不仅无效,甚或是禁忌证。经右心房施行下腔静脉隔膜切开术仅部分患者适用。目前,对多数患者说施行脾肺固定术作门肺分流较为有效。1983年Ono等用脾肺固定术治疗19例MOVC病人,效果良好,术后所有病人无食管曲张静脉复发出血,除1例外,其余18例未再出现腹水。通过初步临床实践,这种手术对MOVC是一种安全、有效的疗法,因此,我们加以推荐。更多还原

【Abstract】 Membranous obstruction of the inferior vena cava (MOVC) is a rare clinicral syndrome. Most of the patients have a long length obstruction in the inferior vena cava (IVC). Diagnosis can be made with cavagraphy. MOVC presents many difficulties in its surgical treatment because of the extensive obstruction in the hepatic veins and hepatic portion of the IVC. portacaval shunt and other types of portal systemic shunts designed to lead portal blood to the IVC are obviously either ineffective or even contraindicant. Transcardiac membranotomy might be successfully performed in some patients with MOVC. However, in most patients, only portapulmonary shunt with splenop neumopexy was indicated. Ono et al, in 1983, reported portapulmonary shunt with splenopneumopexy as a surgical treatment of MOVC Nineteen patients were treated with this procedure and satisfactory results were obtained. Recurrent hemorhage from esophageal varices did not occur in all patients. Ascites were well controlled after operation in all patients except one. Through our primary clinical practice, it was clear that this procedure was safe and effective for the patients with MOVC.更多还原