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[缩窄性心包炎作为肝病的鉴别诊断]

[Constrictive pericarditis as differential diagnosis of hepatic disease].

作者信息

Mustafá R M, Braile D M, Greco O T, dos Santos J L, Ardito R V, Thevenard R

机构信息

Instituto de Moléstias Cardiovasculares (IMC), São José do Rio Preto, SP.

出版信息

Arq Bras Cardiol. 1991 Dec;57(6):473-7.

PMID:1824220
Abstract

Constrictive chronic pericarditis in a 13-year-old male patient was previously treated as chronic hepatitis for seven years, with the use of furosemide and spironolactone. Investigation for diagnosis included chest radiography, echo-doppler-cardiography, thoracocentesis with pleural biopsy and computerized tomography of chest, and showed ventricular diastolic restriction due to constrictive chronic pericarditis. After eight weeks of tuberculostatic treatment, the patient was submitted to hemodynamic study that confirmed the diagnosis and a pericardiectomy was performed. Long-term follow-up showed regression of diastolic restriction and decrease of hepatosplenomegaly and of jugular stasis. Tuberculostatic drugs were given for 12 months postoperatively, associated to corticosteroids.

摘要

一名13岁男性患者的缩窄性慢性心包炎曾被误诊为慢性肝炎长达七年,期间一直使用呋塞米和螺内酯进行治疗。诊断性检查包括胸部X线摄影、超声心动图、胸腔穿刺及胸膜活检以及胸部计算机断层扫描,结果显示为缩窄性慢性心包炎导致的心室舒张受限。经过八周的抗结核治疗后,对该患者进行了血流动力学研究,确诊后实施了心包切除术。长期随访显示舒张受限情况有所缓解,肝脾肿大及颈静脉瘀血症状减轻。术后给予抗结核药物治疗12个月,并联合使用了皮质类固醇药物。

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