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血管贝赫切特综合征的诊断及外科治疗

Diagnosis and surgical treatment results of angio-Beh(c)et syndrome: an analysis of 26 patients

摘要目的 分析血管贝赫切特综合征(BS)的诊断和外科治疗方法及其疗效.方法 回顾性分析2003年1月至2011年4月收治的26例血管BS患者的术前诊断、治疗方法和远期疗效.男性23例,女性3例,年龄20~76岁,平均(37±6)岁.病变仅涉及动脉系统12例,表现为动脉狭窄、闭塞4例,动脉瘤8例;病变仅涉及静脉系统13例,表现为静脉炎或静脉血栓形成;同时涉及动静脉系统1例.全组共有11例患者接受了22例次的外科治疗,包括介入治疗8例次,手术治疗13例次,介入与手术杂交治疗1例次.结果 随访率84.6%(22/26),随访时间3~ 96个月,平均随访时间39.3个月.随访期间病死率23.1%(6/26).接受外科治疗的患者围手术期病死率为1/11.介入治疗患者治愈率7/8,复发率5/8;传统手术患者治愈率8/13,复发率7/8.结论 临床诊断为BS同时合并有各种血管病变的患者,应警惕血管BS,根据病情和病变时机选择恰当的外科治疗方法,是治疗成功的保障.

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abstractsObjective To analyze the diagnosis and surgical treatment results of angio-Beh(c)et syndrome. Methods The clinical data of pre-operation diagnosis, surgical treatment methods and prospective efficacy of 26 patients who were diagnosed as Beh(c)et syndrome between January 2003 and April 2011 was analyzed retrospectively.There were 23 male and 3 female patients,aging from 20 to 76 years with a mean of ( 37 ± 6) years. Among them,3 patients showed the clinical symptoms as arterial stenosis or occlusion,9 patients had aneurysm,13 patients had phlebitis or phlebothrombosis.One patient had both aneurysm and venous thrombosis.Totally 11 patients had experienced 22 cases surgical treatment including interventional therapy for 8 cases,open operation for 13 cases and hybrid operation for 1 case. Results Twenty-two patients ( 84.6% ) were followed up from 3 months to 96 months after various surgical treatment methods.The average follow-up periond was 39.3 months.Totally,perioperative mortality was 1/11 after surgical treatment.Healing rates were 7/8 and 8/13,recurrence rates were 5/8 and 7/8 in patients with interventional therapy compared with that of experiencing open surgery respectively. Conclusions Beh(c)et syndrome patients combined with various vascular lesions should be thought of angio-Beh(c)et syndrome.Choosing correct surgical treatment according to patient's condition and timing of pathological changes are the keys of gaining satisfactory results.

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中华外科杂志

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2012年50卷3期

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