摘要
目的探讨中药土三七治儿童肝小静脉闭塞病的病因及诊断。方法总结2例儿童肝小静脉闭塞病的临床和影像学表现,并复习相关文献。结果患儿临床表现为顽固性大量腹水,肝脏增大,腹壁静脉显露、脐周及侧腹壁无静脉曲张。肝功能异常,腹部增强CT扫描:肝实质内不均匀强化,呈高低密度相间的斑片状,肝静脉显示不清,下腔静脉肝段变扁,远端不扩张亦无侧支循环。根据临床表现,病前1-2月服中药病史,结合腹部CT以及目前肝小静脉闭塞病的诊断标准,诊断为儿童肝小静脉闭塞病。停用土三七并给予抗凝治疗病情逐渐缓解。结论儿童长期服用土三七制剂可致肝小静脉闭塞病。腹部增强CT扫描典型特征有助于临床诊断。抗凝治疗有一定疗效。
objective To investigate the etiology and diagnosis of hepatic veno-occlusive disease（HVOD） of children.Method The clinical and radiological manifestations of two cases of hepatic veno-occlusive disease were described and the related literature were reviewed.Result The two children presented with regractory massice ascites,hepatomegaly,exposured vena epigastrica and umbilical varicosity.Liver function test were abnormal.Enhanced abdomen CT scan showed uneven enhanced areas and low and high density patches in the parenchyma.Venous structure could not be shown clearly.No by-pass could be detected.Two children had taken Chinese traditional herbs 1 to 2 months before deceased.Based on the history of medication taken and abdominal CT scan as well as the diagnostic criteria for liver venules obstruction,liver venule obstructive disease could be diagnosed.Patients condition improved after withdrawal of the herbs.Conclusion Venule obstructive disease could be caused by long-term use of Grnura Root.Abdomen enhanced CT scan has characteristic changes and is helpful for diagnosis confirmation.Anti-coagnulation treatment is effective.
出处
《北京医学》
CAS
2011年第4期317-319,共3页
Beijing Medical Journal
关键词
儿童
肝小静脉闭塞病
中药
Children Hepatic veno-occlusive disease（HVOD） Chinese Medicine
