论文部分内容阅读
目的:探讨布-加综合征肝脏病理学改变与肝静脉、下腔静脉病变的关系。方法:27例布-加综合征患者术前行彩超检查,术中常规行下腔静脉造影和选择性肝静脉造影或经皮肝穿刺肝静脉造影了解肝静脉、下腔静脉阻塞情况;影像引导下经皮肝穿刺组织活检了解肝脏病理学变化。根据病变累及血管分为肝静脉型、下腔静脉型、肝静脉和下腔静脉混合型;根据血管阻塞程度将其分为狭窄型和完全闭塞型。将肝脏病理学改变与肝静脉、下腔静脉阻塞情况进行相关性分析。结果:25例穿刺组织达满意组织学诊断要求,其中肝静脉阻塞型11例,下腔静脉阻塞型4例,肝静脉和下腔静脉混合阻塞型10例;狭窄型7例,完全闭塞型18例。肝纤维化程度与血管阻塞程度密切相关;肝血窦扩张和肝细胞变性与血管阻塞程度无关,肝脏病变与阻塞部位无相关性。结论:肝静脉和下腔静脉阻塞对肝脏的损害程度是一致的,血管阻塞程度较阻塞部位对肝脏损害的影响更大。
Objective: To investigate the relationship between liver pathology and hepatic vein and inferior vena cava lesions in Budd-Chiari syndrome. Methods: Twenty-seven patients with Budd-Chiari syndrome underwent preoperative color Doppler echocardiography. Intraoperative vena cava venography and selective hepatic venography or percutaneous transhepatic hepatic venography were used to investigate the occlusion of the hepatic veins and inferior vena cava. Imaging guidance Percutaneous liver biopsy tissue biopsy to understand the pathological changes in the liver. According to the vascular involvement of the lesion is divided into hepatic vein type, inferior vena cava type, hepatic vein and inferior vena cava mixed type; according to the degree of vascular occlusion will be divided into narrow and complete occlusion. Pathological changes of liver and hepatic vein, inferior vena cava occlusion were analyzed. Results: 25 cases of puncture tissue satisfied the requirements of histological diagnosis, including hepatic vein occlusion in 11 cases, inferior vena cava obstruction in 4 cases, hepatic vein and inferior vena cava mixed occlusion in 10 cases, stenosis in 7 cases, complete occlusion in 18 cases example. The degree of hepatic fibrosis was closely related to the degree of vascular occlusion. The expansion of hepatic sinusoids and the degeneration of hepatocytes had no relation with the degree of vascular obstruction. There was no correlation between the liver lesion and occlusion sites. Conclusion: The extent of hepatic vein damage is consistent with the occlusion of the hepatic vein and inferior vena cava, and the degree of vascular obstruction is more affected than the occlusion site.