CAJ | 학술논문

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。
목적탐토토삼칠치간두조새종합정（ HSOS）적발병궤제、진료방법급체회。방법회고성분석7례HSOS적림상자료，병진행수방。결과7례HSOS주요림상표현위복창、간구동통、간종대、복수정양성등。혈소판계수（ PLT）、혈소판압적（ PCT）대다저하，간공능손해대다교경。초성검사균견간장종대，간정맥변세、벽증후급류속완만，복강적액등。 CT표현위동맥기간실질경도불균균반편상강화혹무강화；문정맥기정“조상”강화、불균균반편상강화，간정맥현시불청혹위세선상；연지기간실질강화범위축점확대。1례경피간천자활검견간세포변성、배사，간두확장、충혈，홍세포진입Diss간극。4례경내과치료후점강복출원，3례사망。결론 HSOS돌출적림상표현위문정맥고압증，초성、CT등영상학검사대본병적진단화감별진단구유중대개치。
s:Objective To explore the pathogenesis, diagnosis and treatment methods and experience of hepatic sinus congestion syn-drome ( HSOS) caused by soil notoginseng.Methods Retrospective analysis the clinical data of 7 cases of HSOS, and follow-up.Results The main clinical manifestations of 7 cases of HSOS were abdominal distention, liver area pain, hepatomegaly, ascites, etc.The platelet count and platelet deposited were mostly low, liver function damage was mostly light.The ultrasonic examination showed that the liver was en-larged, and the hepatic veins were thin, wall thickening and flow velocity was slow, and peritoneal effusion, etc.CT showed mild patchy en-hancement or no enhancement in the arterial phase of liver parenchyma;"Ungual state"was"claw like"enhancement, patchy enhancement, and hepatic veins were not clear or thin;delay the liver parenchyma reinforcement scope expanding gradually.1 case with percutaneous liver puncture biopsy showed liver cell degeneration, necrosis, hepatic sinus expansion, hyperemia, red blood cells into the Diss clearance.4 cases were discharged from hospital after treatment and 3 cases died.Conclusion The clinical manifestation of HSOS is portal hypertension, ultra-sound, CT imaging examination are of great value in the diagnosis and differential diagnosis of the disease.