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目的探讨土三七致肝窦阻塞综合征(HSOS)的发病机制、诊疗方法及体会。方法回顾性分析7例HSOS的临床资料,并进行随访。结果 7例HSOS主要临床表现为腹胀、肝区疼痛、肝肿大、腹水征阳性等。血小板计数(PLT)、血小板压积(PCT)大多低下,肝功能损害大多较轻。超声检查均见肝脏肿大,肝静脉变细、壁增厚及流速缓慢,腹腔积液等。CT表现为动脉期肝实质轻度不均匀斑片状强化或无强化;门静脉期呈“爪状”强化、不均匀斑片状强化,肝静脉显示不清或为细线状;延迟期肝实质强化范围逐渐扩大。1例经皮肝穿刺活检见肝细胞变性、坏死,肝窦扩张、充血,红细胞进入Diss间隙。4例经内科治疗后渐康复出院,3例死亡。结论 HSOS突出的临床表现为门静脉高压症,超声、CT等影像学检查对本病的诊断和鉴别诊断具有重大价值。
Objective To explore the pathogenesis, diagnosis and treatment of hepatosomatous obstruction syndrome (HSOS) induced by. Methods The clinical data of 7 cases of HSOS were retrospectively analyzed and followed up. Results The main clinical manifestations of 7 cases of HSOS were abdominal distension, liver pain, hepatomegaly, ascites and so on. Platelet count (PLT), platelet pressure (PCT) mostly low liver damage most of the lighter. Ultrasound examination showed liver enlargement, hepatic vein thinning, wall thickening and slow flow, ascites and so on. CT showed arterial phase of hepatic parenchyma mild uneven patch enhancement or no enhancement; portal vein was “claw ” enhancement, uneven patchy enhancement, hepatic veins were unclear or thin line; delay Liver parenchyma range gradually expanded. Transcutaneous liver biopsy in 1 case of liver cell degeneration, necrosis, sinusoidal dilation, congestion, red blood cells into the Diss gap. Four patients recovered from hospital after medical treatment and three died. Conclusions The clinical manifestation of HSOS is of great significance in the diagnosis and differential diagnosis of portal hypertension, ultrasound and CT.