肝癌早期诊断标志物的研究进展

我国是肝病大国,尤其是原发性肝癌（primary liver cancer,PLC,以下简称肝癌）已成为临床上常见的消化系统恶性肿瘤之一。肝癌在恶性肿瘤中位居世界第五位,我国位居第三位。目前其发病率在世界范围内呈上升趋势,而我国是全球肝癌发病率最高的国家。     

肝移植术后原发性肺隐球菌病3例临床分析

目的探讨原位肝移植术后原发性肺隐球菌病(PPC)的诊断和治疗。方法收集武警总医院2005年4月～2009年12月1302例原位肝移植术后3例并发PPC患者的临床资料,结合相关文献进行复习。结果 3例患者分别在肝移植术后6、13、31个月并发PPC;肺穿刺活组织病理学检查确诊1例,临床诊断2例(乳胶凝集试验阳性及CT检查肺部阴影);均采用单药治疗,氟康唑治疗1例,伊曲康唑治疗2例,均未出现药物相关不良反应。结论 PPC多发生在肝移植术后中、远期,缺乏特征性临床表现和影像学特征,肺穿刺活组织学检查是PPC的确诊手段,唑类抗真菌药对PPC有效且无明显不良反应。     

肝移植术后原发性肠结核一例

1 临床资料 患者男,41岁.因间断发热1个月于2009年8月8日收治入院.患者于2009年5月5日因原发性肝癌、乙型病毒性肝炎后肝硬化(失代偿)在我院行原位肝移植术.术后采用他克莫司+吗替麦考酚酯+甲基泼尼松龙三联方案治疗,肝功能逐渐恢复正常.2009年7月5日患者出现间断发热、腹泻,无咳嗽、咳痰、腹痛,无尿频、尿急、尿痛,体温波动在37.3～38.4℃.患者既往无结核病史,术后无明确结核病患者接触史.体格检查:体温37.2℃,脉搏74次/min,呼吸18次/min,血压110/78 mm Hg(1 mm Hg=0.133 kPa);腹部平坦,上腹部可见"人"字形手术瘢痕,未见腹壁静脉曲张、胃肠型及蠕动波;T管固定在位,引流通畅;腹软,无柔韧感,未扪及包块,无压痛、反跳痛及肌紧张,肝脾肋下未扪及;全身浅表淋巴结未触及肿大,心肺未见异常.     

肝血管外皮细胞瘤一例报告及文献复习

1 病例报告 患者女,40岁,因右上腹隐痛不适伴轻度乏力2个月,于2009-03-13入院.患者无明显诱因出现右上腹隐痛不适伴轻度乏力,无发热、尿黄,无恶心、呕吐,无腹痛、腹泻.入院后查体:营养中等,巩膜、皮肤无黄染,无肝掌及蜘蛛痣,全身浅表淋巴结无肿大,心、肺(一),腹部平坦,未见肠型及蠕动波,未见腹壁静脉曲张,右季肋部饱满,锁骨中线肋缘下可触及肿大肝脏,质韧,轻度压痛,未触及脾脏,肝肾无叩痛,移动性浊音(一),肠鸣音3～5次/min.     

肝移植术后门静脉狭窄-肠系膜上静脉血栓的影像诊断

Portal vein stricture complicated with superior mesenteric venous thrombosis is rarely seen in clinical practice. On December 26, 2009, a 51-year-old male patient who had a liver transplantation history was admitted to The General Hospital of Chinese People's Armed Police Forces with the chief complaint of intermittent abdominal pain and diarrhea.A plain and enhanced CT scan showed that the portal vein was constrictive and thrombosis had formed in the main trunk of the superior mesenteric vein, and varicose veins were seen in surrounding tissues of the esophagus. Edema was observed at the end of the ileum and cecum. The results of colonoscopy showed inflammatory changes and varicose veins of the colon. The patient received medical treatment. The thrombosis was dissolved 9 days later, and all symptoms disappeared 12 days later.