布加综合征的临床分析

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1、布加综合征的临床分析［摘耍］日的分析布加综合征的临床特点，以提高对该病的认识，减少误诊。方法回顾性分析19例布加综合征患者的病史、症状、体征、实验室检查、影像学检查及治疗随访情况。结果布加综合征患者的职业多为农民及打工者(6&4%),临床表现主要为腹胀(78.9%).肝脾肿大(占47.4%及63.2%)、侧腹壁静脉曲张(57.9%).腹水(36.9%)、下肢水肿(26.3%).下肢静脉曲张、色素沉着或溃疡(31.6%)。彩色多普勒和磁共振血管成像的诊断率达80%和84.6%。16例患者行介入或手术治疗，其中12

2、例介入治疗者测下腔静脉直径由术前(24.58±3.85)mm缩小为(17.92±3.05)mm(P<0.01),下腔静脉压力由术前(3.08±0.38)kPa降为术后(1・89±0.28)kPa(PV0.01)。结论门脉高压表现重或伴有下腔静脉高压而肝人、肝功能损害轻者，应高度怀疑木病。彩色多普勒和磁共振血管成像是重要的检查方法，早期诊断及治疗对预后有重要的影响。介入手术是有效的治疗手段。［关键词］布加综合征；影像学；误诊；介入；手术［中图分类号］R575［文献标识码］B［文章编号］1673-9701(2011

3、)22-38-03Budd-ChiariSyndromeTAOLipinglYANGXiaolei2WUXiaolilHUANGZhimingl1.DepartmentofGastroenterologyoftheFirstAffiliatedHospitalofWenzhouMedicalCollege,Wenzhou325000,China；2.DepartmentofGeneralPracticeoftheFirstAffi1iatedHospitaiofWenzhouMedicalCollege,Wen

4、zhou325000,China.[Abstract]ObjectiveToexploretheclinicalfeaturesofBudd-Chiarisyndromeforfurtherunderstanclingofthediseaseanddecreasingthemisdiagnosis.MethodsNinteencaseswereanalyzedretrospectivelyinhistory,symptoms,physicalsign,laboratoryexamination,imaginge

5、xamination,therapyandfollow-up.ResultsMostofthepatientswerefarmersandworkers(68.4%)•Abdominaldistention(78.9%),hepatomegalia(47.4%),splenomegalia(63.2%),subcutaneousvaricosveinoflatero-abdominalwal1(57.9%),ascites(36.9%),edemaoflowerextremity(26.3%),varicose

6、veins,pigmenlationandulceroflowerextremity(31.6%)wasthemostcommonclinicalmanifestation.ThediagnosticcoincidenceofcolorDopplerandmagneticresonanceangiographyreached80%and84.6%,respectively.16casesacceptedinterventionaltherapyorsurgicaloperationandhadagoodprog

7、nosis.Thediameterofinderiorvenacavain12caseswhoreceivedinterventionaltherapyfailedfrom(24.58+3.85)mmbeforetheoperationto(17.92±3.05)mmaftertheoperation(P<0.01).Andpressureofinderiorvenacavadecreasedfrom(3.08±0.38)kPato(1.89+0.28)kPa(P<0.01).ConclusionWeshoul

8、dthinkoftheprobabi1ityofBudd-Chiarisyndromewhenthepatientshaveanobviousmanifestationofportalhypertension,especiallywithhypertensionofinferiorvenaandhepatauxebutslightdamageofliverfunction.ColorD