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肝门静脉积气:使用 PUBMED 和 MEDLINE 数据库分析 131 例病例报告。

Hepatic portal venous gas: A case report and analysis of 131 patients using PUBMED and MEDLINE database.

机构信息

Intensive Care Unit, Dazhou Central Hospital, Dazhou, Sichuan, China.

Intensive Care Unit, Dazhou Central Hospital, Dazhou, Sichuan, China.

出版信息

Am J Emerg Med. 2021 Jul;45:506-509. doi: 10.1016/j.ajem.2020.06.085. Epub 2020 Jul 14.

DOI:10.1016/j.ajem.2020.06.085
PMID:32739095
Abstract

OBJECTIVE

Hepatic portal pneumatosis has a high mortality rate, and whether surgical intervention is necessary remains controversial. This experiment retrospectively analyzed the etiology, treatment methods and prognosis of adult patients with hepatoportal pneumocele to provide a theoretical basis for the treatment of this disease.

METHODS

We analyzed the clinical symptoms and post-treatment of a 43-year-old male patient with HPVG admitted to hospital. We retrieved adult non-iatrogenic HPVG cases with complete clinical data in PUBMED,  and MEDLINE and other databases were retrieved for analysis, and summarized the pathogenesis, clinical symptoms, pathogenesis, pathogenesis and prognosis of different treatment schemes were summarized.

RESULTS

The main etiology of HPVG are intestinal ischemia (27%), severe enteritis/intestinal perforation/intestinal fistula (16%), intestinal obstruction (7%), abdominal infection (7%), gastric diseases (11%), appendicitis and its complications (5%), acute hemorrhage or necrotizing pancreatitis (5%), Crohn's disease and its complications (4%), trauma (traffic accidents, falls) (2%), diverticulitis and perforation (6%), nephrogenic diseases (4%), spontaneous pneumohepatic portal vein (2%), other reasons (4%). And after analysis, we found that the survival rate of patients treated by surgery was 40.5% and the mortality rate was 19.1%, the difference between the two was significant.

CONCLUSIONS

Etiology should be actively explored and surgical treatment is necessary.

摘要

目的

门静脉积气的死亡率很高,是否需要手术干预仍存在争议。本实验通过回顾性分析成人肝门静脉积气患者的病因、治疗方法和预后,为该病的治疗提供理论依据。

方法

我们分析了一位 43 岁男性患者因肝静脉内门脉高压症(HPVG)住院的临床症状和治疗结果。我们在 PUBMED、MEDLINE 等数据库中检索了成人非医源性 HPVG 病例,检索了完整的临床资料,对其发病机制、临床症状、不同治疗方案的发病机制、发病机制和预后进行了总结。

结果

HPVG 的主要病因是肠缺血(27%)、严重肠炎/肠穿孔/肠瘘(16%)、肠梗阻(7%)、腹部感染(7%)、胃疾病(11%)、阑尾炎及其并发症(5%)、急性出血或坏死性胰腺炎(5%)、克罗恩病及其并发症(4%)、创伤(交通事故、跌倒)(2%)、憩室炎和穿孔(6%)、肾病(4%)、自发性肝门静脉积气(2%)、其他原因(4%)。分析后发现,手术治疗的患者存活率为 40.5%,死亡率为 19.1%,两者差异有统计学意义。

结论

应积极探索病因,并进行手术治疗。

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