[1]唐亮,邱秋,徐福民,等.3 576例区域性门脉高压症患者临床特征的系统分析[J].第三军医大学学报,2019,41(22):2217-2222.
 TANG Liang,QIU Qiu,XU Fumin,et al.Clinical characteristics of regional portal hypertension in 3 576 patients: a systematic analysis[J].J Third Mil Med Univ,2019,41(22):2217-2222.
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3 576例区域性门脉高压症患者临床特征的系统分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第22期
页码:
2217-2222
栏目:
临床医学
出版日期:
2019-11-30

文章信息/Info

Title:
Clinical characteristics of regional portal hypertension in 3 576 patients: a systematic analysis
作者:
唐亮邱秋徐福民王文生王纯吴丹朱光曦刘凯军陈东风
陆军军医大学(第三军医大学)大坪医院消化内科 ; 重庆市合川区人民医院消化内科
Author(s):
TANG Liang QIU Qiu XU Fumin WANG Wensheng WANG Chun WU Dan ZHU Guangxi LIU Kaijun CHEN Dongfeng

Department of Gastroenterology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, 400042; 2Department of Gastroenterology, Hechuan District People’s Hospital, Chongqing, 401520, China

关键词:
区域性门脉高压病因临床特征CT脾切除术
Keywords:
regional portal hypertension etiology clinical features tomography X-ray computed splenectomy
分类号:
R195.4; R657.4
文献标志码:
A
摘要:

目的 分析3 576例区域性门脉高压症(regional portal hypertension, RPH)患者的临床特征。方法 检索1980年1月至2019年6月我国RPH相关文献,纳入文献150篇,共3 576例RPH患者。总结RPH患者的性别、年龄、地域分布、病因、临床表现、检查方法、治疗手段及预后情况。结果3 576例RPH患者中男性2 340例(65.44%),女性1 236例(34.56%),平均年龄为50.23岁。病因以胰源性多见(92.03%),其次为脾源性(1.68%)和腹膜后源性(0.67%)。胰源性RPH的主要病因分别是胰腺肿瘤(34.40%)、慢性胰腺炎(29.67%)、胰腺假性囊肿(16.28%)、急性胰腺炎(7.27%)等。RPH的临床表现主要有脾肿大(68.47%)、上消化道出血(54.92%)、上腹部不适或上腹痛(38.56%)和孤立性胃底静脉曲张(71.44%)等。RPH的诊断主要依据CT检查(24.41%),单独的胃镜或彩超诊断价值有限。RPH的治疗方式包括脾切除术(70.92%)、内镜下治疗(4.65%)、脾动脉栓塞或结扎(3.97%)等。上述方法治疗好转率为83.20%,但也有2.20%的患者因上消化道大出血死亡。结论 RPH的发病率男性高于女性,病因以胰腺疾病为主。单一检查项目中CT对于RPH诊断价值最大。脾切除术是RPH并发上消化道出血患者的首选治疗方式,该病的预后依赖于RPH的病因。

Abstract:

Objective To analyze the clinical characteristics of 3 576 patients with regional portal hypertension (RPH). MethodsWe searched the electronic databases for studies of RPH published in China from January, 1980 to June, 2019, and retrieved 150 articles involving a total of 3 576 patients with RPH. The gender, age, geographical distribution, etiology, clinical manifestations, examination methods, treatment and prognosis of the patients were analyzed. ResultsAmong the 3 576 patients with RPH, 2 340 (65.44%) were males and 1 236 (34.56%) were females with a mean age of 50.23 years. The causes of RPH were mostly pancreatic diseases (92.03%), spleen diseases (1.68%) and retroperitoneal diseases (0.67%). Pancreatic RPH occurred often secondary to pancreatic tumors (34.40%), chronic pancreatitis (29.67%), pancreatic pseudocysts (16.28%) and acute pancreatitis (7.27%). The main clinical manifestations of RPH included splenomegaly (68.47%), upper gastrointestinal bleeding (54.92%), upper abdominal discomfort or pain (38.56%), and isolated gastric fundus varices (71.44%). The diagnosis of RPH relied heavily on CT findings (24.41%), and the diagnostic value of gastroscopy or color Doppler ultrasound alone was limited. The treatments of RPH included splenectomy (70.92%), endoscopic treatment (4.65%), splenic artery embolization or ligation (3.97%); these treatments resulted in a disease improvement rate of 83.20%, but still 2.20% of the patients died due to upper gastrointestinal hemorrhage. ConclusionThe incidence of RPH is higher in male than in female patients, and pancreatic disease is the most common etiology. For diagnosis with a single modality, CT scan has the greatest diagnostic value for RPH. Splenectomy is the preferred treatment for RPH complicated by upper gastrointestinal bleeding, and the prognosis of the patients is associated with the etiology of RPH.

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更新日期/Last Update: 2019-11-21