内科腹水的鉴别诊断：临床病例

Differential diagnosis of ascites in internal medicine: clinical case.

作者信息

Tikhonov I N, Zharkova M S, Maevskaya M V, Zozulya V N, Nekrasova T P, Arslanyan M G, Musina N P, Tatarkina M A, Rzaev R T, Puzakov K B, Ivashkin V T, Malikova M S

机构信息

Scientific Research Department of Innovative Therapy of the Scientific and Technological Park of Biomedicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia.

V.H. Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia.

出版信息

Ter Arkh. 2018 Aug 27;90(8):74-80. doi: 10.26442/terarkh201890874-80.

DOI:10.26442/terarkh201890874-80

PMID:30701950

Abstract

Ascites and hydrothorax may be the symptoms of congestive heart failure and do not always reflects presense of the decompensated liver cirrhosis. Clinical examination of patient with chronic hepatitis C which cyanosis of the lips, cervival veins pulsation, a triple heart rhythm indicated on pathology of the heart (constrictive pericarditis), which was confirmed by instrumental methods. Congestive heart failure has lead to the congestive liver in a young female patient. Regression of all the symptoms of heart failure occurred after surgical treatment (pericardectomy).

摘要

腹水和胸腔积液可能是充血性心力衰竭的症状，并不总是反映失代偿期肝硬化的存在。对一名慢性丙型肝炎患者进行临床检查时，发现其嘴唇发绀、颈静脉搏动、出现提示心脏病变（缩窄性心包炎）的三联心律，这一点通过仪器检查得到了证实。充血性心力衰竭导致一名年轻女性患者出现充血性肝肿大。手术治疗（心包切除术）后，心力衰竭的所有症状均有所缓解。