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《先天性肝纤维化的临床分析-论文.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、-980·胃肠病学和肝病学杂志2013年10_月第;鲞Q塑!!!!!!旦!P!!:兰!!:!doi:10.3969/j.issn.1006—5709.2013.10.009先天性肝纤维化的临床分析李楠,王湛博,王娟,江华,刘迎娣解放军总医院1.消化内科;2.病理科,北京100853【摘要】目的探讨先天性肝纤维化(CHF)的临床特点,提高对该病的认识。方法对8例CHF患者的临床症状、体征、实验室检查、影像学检查、病理学特征、治疗及随访进行回顾性分析。结果8例患者均经肝组织病理诊断为CHF,8例均有门脉高压症状,7例呕血、黑便,8例肝脾肿大(5例脾
2、切除术后),5例肝硬化,5例腹水,3例肝功能轻度异常,1例伴有先天性胆总管囊肿,2例伴有先天性肝内胆管扩张(Caroli病),3例伴有双肾弥漫性实质损害,3例伴有门静脉海绵样变性。入院前5例因出血行脾切除术,再发出血后行内镜下治疗;6例经内镜下治疗效果良好。结论CHF临床上罕见,大部分患者在年幼时发病,对于有门脉高压或表现为消化道出血、肝脾肿大的年轻患者应想到该病的可能,尽早行肝组织活检病理检查以协助诊治。内镜治疗和脾切除术是治疗的主要方法。【关键词】先天性肝纤维化;门脉高压;诊断;治疗中图分类号:R575.2文献标识码:A文章编号:1006—
3、5709(2013)10—0980—03收稿日期:2013-O1-24ClinicalanalysisofcongenitalhepaticfibrosisLINan,WANGZhanbo,WANGJuan,JIANGHua,LIUYingdi1.DepartmentofGastroenter01ogy;2.DepartmentofPathology,ChinesePLAGeneralHospital,Beijing100853,China【Abstract】0bjectiveToimprovetheunderstandingofthedise
4、asebyanalyzingtheclinicalfeaturesofcongenitalhepaticfibrosis(CHF).MethodsTheclinicalsymptoms,signs,laboratoryexamination,imagingstudies,pathologiccharacteristics,treatmentandfollow-upof8patientswithCHFwereanalyzedretrospectively.ResultsEightpatientswithCHFwereconfirmedbypath
5、ologicalresults.Maletofemalewas5:3,agerangingfrom11to47yearsold,withmeanageof(20.38土11.22)yearsold.AllthepatientswithCHFpresentedthesymptomsofportalhypertension.7patientswithhematemesisandmelena,8patientswithhepato8p1enomegaly(5patientshadbeentreatedwithsplenecto—my),5patien
6、tswithcirrhosis,5patientswithascites,3patientswithmildliverdysfunction,1patientwithcongenitalcystofcommonbileduct,2patientswithcongenitalintrahepaticbileductdilatation,3patientswithrenaldiffuseparen.chymallesions,3patientswithcavernoustransformationofportalvein.Fivepatientsu
7、nderwentsplenectomyduetogas.trointestinalbleedingandreceivedendoscopictherapyafterrecurrenceofhemorrhage.Theendoscopictherapywasefec.tivein6patients.ConclusionCHFisararedisease,mostofthepatientsarefoundinadolescent.CHFshouldbeconsideredwhilegastroesophagealvaricealbleedingor
8、thesplenomegalyarefoundinyoungpatients.Liverbiopsyforpathologicexaminations
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