布加综合征的临床分析(1)
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[摘要] 目的 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(68.4%)，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(P <0.01)。结论 门脉高压表现重或伴有下腔静脉高压而肝大、肝功能损害轻者，应高度怀疑本病。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)22-38-03
Budd-Chiari Syndrome
TAO Liping1 YANG Xiaolei2 WU Xiaoli1 HUANG Zhiming1
1. Department of Gastroenterology of the First Affiliated Hospital of Wenzhou Medical College， Wenzhou 325000， China；2. Department of General Practice of the First Affiliated Hospital of Wenzhou Medical College， Wenzhou 325000， China.
[Abstract] Objective To explore the clinical features of Budd-Chiari syndrome for further understanding of the disease and decreasing the misdiagnosis. Methods Ninteen cases were analyzed retrospectively in history， symptoms， physical sign， laboratory examination， imaging examination， therapy and follow-up. Results Most of the patients were farmers and workers (68.4%). Abdominal distention (78.9%)， hepatomegalia (47.4%)， splenomegalia (63.2%)， subcutaneous varicos vein of latero-abdominal wall (57.9%)， ascites (36.9%)， edema of lower extremity (26.3%)， varicose veins， pigmentation and ulcer of lower extremity (31.6%) was the most common clinical manifestation. The diagnostic coincidence of color Doppler and magnetic resonance angiography reached 80% and 84.6%， respectively. 16 cases accepted interventional therapy or surgical operation and had a good prognosis. The diameter of inderior vena cava in 12 cases who received interventional therapy falled from (24.58±3.85)mm before the operation to( 17 ......
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