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目的分析乙肝后肝硬化的发热原因。方法对73例患者的发热原因进行分析、汇总,同时对患者的发热原因与肝功能情况进行分类。结果乙肝后肝硬化伴发热的原因,以感染为主,占79.45%,感染源以细菌感染为主,占感染性发热的77.59%,其中自发性细菌性腹膜炎占感染性发热原因的58.62%,占所有发热原因的46.58%,肝功能越差发热的发生率越高。结论乙肝后肝硬化容易出现发热,发热以感染性发热为主,肝功能水平与发热有直接关系。 相似文献
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130例肝炎肝硬化患者发热临床分析 总被引:1,自引:0,他引:1
肝硬化合并发热甚为常见,原因较为复杂,其中细菌感染后发热占绝大多数,如失去及时诊断和正确治疗的机会,可使肝硬化病情加重,迅速进展为肝细胞功能衰竭,严重影响愈后。现对我院6年来收治的肝硬化合并发热患者130例进行回顾性研究,现报告如下。 相似文献
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发热原因待查(fever of unknown origin, FUO) 是指体温在38.3℃以上超过3 周,住院1 周经过常规检查仍不 能明确病因者。导致FUO 的疾病有200 种以上。文章介绍了发热原因待查的诊断思路,从确定FUO、详细的病史、 全面的体检与辅助检查多个方面进行了阐述,特别提出了应该注意的几个问题,供临床医生参考。 相似文献
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不明原因发热103例病因分析 总被引:9,自引:0,他引:9
发热是许多疾病的一种共同表现 ,常为首发甚至是唯一的症状 ,除了大多数短程发热的急性、自限性感染性疾病和易于明确诊断的发热性疾病外 ,不明原因的长程发热均称为未明热 (feverofunknownorigin ,FUO)。不明原因长期发热一直是临床上诊断的难题之一 ,即使经临床经验丰富的医师诊治 ,并运用多种高新的辅助检查方法 ,仍有约10 %的FUO患者始终不能明确病因[1] 。因此我们有必要对不明原因长期发热病例进行回顾性分析 ,探索规律 ,总结经验 ,吸取教训 ,以不断提高FUO的早期诊断与治疗的水平。我们统计了长征医院 1991~ 1999年期间收治的 1… 相似文献
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目的分析肺结核患者在使用抗结核化学药物治疗过程中出现发热的原因。方法对2003—2006年在抗结核治疗中出现发热的112例住院病人进行回顾性分析。结果112例病人共出现发热140例次,总结发热原因可分为6大类,按照所占比例依次为:非结核性感染、结核性发热、药物反应、支气管镜检查术后、合并肺外结核和其他合并症。院内获得性感染占非结核性感染例数的98%。结核性发热与低蛋白血症有一定相关性。结论以院内获得性感染为主的非结核性感染是所有发热原因中最多见者,其次要警惕药物热和合并肺外结核。 相似文献
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目的了解结核专科医院发热病人的临床特点,做好各种呼吸道传染病的鉴别诊断。方法选取我院2004年1月~2007年12月收治的发热门诊病人384例,对其病因、流行病学史、伴随症状、血液分析、胸部X线表现及诊断情况进行分析。结果结核专科发热病人临床特点为:1、患者以16—40岁青壮年为主(61.46%);热度多为38~40℃的中高度热;2、病因以原有肺结核基础病或外院疑诊肺结核的占多数(73.96%);3、多数患者伴随咳嗽等呼吸道症状;4、胸片大多显示肺部不同部位、混合性病变;5、血液分析显示白细胞计数在正常至10×10^9/L以上为多。结论结核专科发热病人临床特点无特异性,发热门诊医生必须重点突出与传染性发热疾病的鉴别诊断。 相似文献
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TAKAHIRO EZAKI YASUNORI YOSHIDA TAKESHI OKAMURA TAKAYUKI SHIRAKUSA 《Journal of gastroenterology and hepatology》1993,8(2):199-201
A case of hepatocellular carcinoma (HCC) in a cirrhotic liver which became detectable within a month is reported here. The patient was admitted for treatment of oesophageal varices due to Child's C grade liver cirrhosis. A hepatic angiogram was performed before the treatment and showed no neovasculature. After undergoing variceal treatment by injection sclerotherapy, the patient underwent another angiogram 28 days later in order to measure the efficacy of the treatment. The second angiogram revealed the emergence of small multiple neovasculatures throughout the entire liver. From the angiographic findings, those tumours were considered to be HCC. The present report suggests that small HCC latent in a cirrhotic liver can thus acquire neovasculature within a short period of time. 相似文献
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肝硬化大鼠食管一氧化氮合酶分布定位研究 总被引:7,自引:2,他引:5
目的探讨一氧化氮(NO)在肝硬化食管静脉曲张及血流动力学改变中的作用。方法应用还原型辅酶Ⅱ-黄递酶(NADPH-d)组化染色观察CCI4所致肝硬化大鼠食管下段一氧化氮合酶(NOS)分布;应用荧光法检测大鼠食管组织匀浆及血清中NO含量;应用57Co标记微球测定大鼠血流动力学指标。结果肝硬化鼠食管粘膜及粘膜下血管内皮NOS呈强阳性反应,而正常鼠则呈弱阳性或阴性反应;肝硬化大鼠食管及血清中NO含量显著升高。且全部出现门脉高压和高动力循环状态。结论NO在肝硬化大鼠食管静脉曲张及血流动力学改变中可能起重要作用。 相似文献
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饮酒对乙型肝炎病程影响的临床流行病学研究 总被引:14,自引:0,他引:14
目的:研究饮酒对乙型肝炎病毒(HBV)感染之病程经过的影响。方法:1392例男性成年HBV感染者依饮酒与否分为两组,各以复查时或死亡诊断为转归诊断并同初诊诊断作对比分析。结果:两组的病情发展(持续携带→慢性肝炎→肝硬化→肝细胞癌)比例均具统计学显著性差异。饮酒组的脂肪肝B超显像和血清抗-HCV阳性率亦明显高于不饮酒组。结论:本文研究分析认为,饮酒对于HBV感染的病变过程确有促进影响。 相似文献
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To examine the degree of influence of the hepatic artery on microcirculation in the liver, microscopic observation of blood flow in the hepatic minute blood vessels and the sinusoids and pressure measurements at key points in hepatic vascular pathways in vivo were performed before and after hepatic artery ligation in normal and cirrhotic rats. In normal rats, portal vein pressure (109 mmH2O) fell 10 mmH2O after hepatic artery ligation, but the pressures of the terminal portal venule, the terminal hepatic venule and the inferior vena cava did not change. In cirrhotic rats, portal vein pressure (206 mmH2O) and terminal portal venule pressure (106 mmH2O) fell 23 and 10 mmH2O after hepatic artery ligation respectively: the pressures in the terminal hepatic venule and the inferior vena cava did not change. These results suggests that the pressure transmitted from the hepatic artery was mostly supplied to the intrahepatic portal vein in normal rats and both to the intrahepatic portal vein and to the sinusoids in cirrhotic rats. In both normal and cirrhotic rats, however, the pressure transmitted from the hepatic artery was about 10 per cent of the initial portal vein pressure, and the blood flow in minute vessels and sinusoids did not change after hepatic artery ligation. Accordingly, it is believed that the hepatic artery plays only a small role in the haemodynamics of the liver in both normal and cirrhotic rats, irrespective of the distribution and manner of the hepatic arterial termination. 相似文献
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肝硬变肝癌的细菌感染 总被引:6,自引:0,他引:6
目的进行肝硬变肝癌患者细菌感染的流行病学研究。方法回顾性地研究了719例肝硬变肝癌患者各种细菌感染的发生率。结果全组细菌感染发生率为15.4%,当肝硬变程度按 Child-Pugh 分级时,A 级感染率为2.3%,B 级为8.0%,C 级为26.4%,随着肝硬变程度的加剧,细菌感染率越高,严重的细菌感染发生在 B 级和 C 级肝硬变肝癌患者。结论肝癌患者对细菌的易感性主要与肝硬变有关,而与肝癌本身无关。 相似文献
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Primary hepatic malignant fibrous histiocytoma (MFH) is rarely encountered. There have been no reports to date of hepatic MFH associated with liver cirrhosis. The presence of liver cirrhosis is considered an adjunctive feature favoring sarcomatoid hepatocellular carcinoma (HCC) in the diagnosis of spindle cell tumors in liver. We describe here a 59-year-old man with liver cirrhosis due to hepatitis B virus infection 20 years ago. On abdominal computed tomography scanning, two distinct hepatic masses were identified in the background of cirrhosis, which had different radiological features from conventional HCC. He underwent segmentectomy for removal of the tumors. The pathological examination of surgically resected specimen revealed the large malignant spindle cell tumor and small conventional HCC. Additional tissue sampling and immunohistochemical stainings demonstrated that the spindle cell tumor was consistent with MFH. On the post-operative follow-up for 21 mo, a round mass showing similar radiological findings for the previous MFH was appeared on the surface of resection margin, suggesting the recurrence. Despite its rarity, hepatic MFH should be considered during differential diagnosis, even in cirrhotic patients, and extensive tissue sampling and immunohistochemical analyses are necessary in the diagnosis of hepatic spindle cell tumors. 相似文献
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Partial hepatic resection for hepatocellular carcinoma 总被引:2,自引:0,他引:2
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研究丹参注射液对门脉高压血流动力学的影响.方法用胆总管结扎法制作犬门脉高压模型.分别测定用药前后门脉高压犬血流动力学变化.结果丹参静脉给药后30min,肝硬变犬门静脉压(Ppv,256kPa±030kPa→198kPa±033kPa)、嵌塞肝静脉压(WHVP,217kPa±036kPa→184kPa±031kPa)、肝静脉压力梯度(HVPG,093kPa±033kPa→066kPa±043kPa)显著下降(P<005~001),给药后60min,上述指标降至最低点(各为182kPa±033kPa,170kPa±030kPa,060kPa±043kPa),但对平均动脉压(MAP)、心率(HR)、下腔静脉压(ICVP)和正常犬血流动力学无显著影响(P>005).结论丹参为一疗效确切而无副作用的降门脉压药物. 相似文献
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目的研究肝硬化大鼠膈肌损伤的作用机制。方法SD大鼠16只被随机分成对照组(n=8)和实验组(n=8)。实验组大鼠皮下注射40?l4制备肝硬化动物模型,共成模8只。应用体外灌流大鼠膈肌条的方法,分别测量其单收缩力(Pt),最大强直张力(Po),峰值收缩时间(CT),半舒张时间(1/2RT),张力最大上升速率( dT/dtmax),张力最大下降速率(-dT/dtmax),并测量在10、20、40、60、100Hz的张力,绘制力—频率曲线,同时测定膈肌组织中SOD、SDH、NOS、Na -K -ATPase、Ca2 -Mg2 ATPase的活性及MDA含量,并观察膈肌的形态学变化。结果肝硬化大鼠膈肌Pt,Po, dT/dtmax,-dT/dtmax均低于对照组(P<0.01);CT,1/2RT高于对照组(P<0.05);给予10、20、40、60、100Hz的电压刺激膈肌时,肝硬化大鼠膈肌张力明显低于对照组(P<0.05);肝硬化大鼠膈肌组织SOD、SDH、Na -K -ATPase,Ca2 -Mg2 ATPase活性明显低于对照组(P<0.05),而MDA含量和NOS活性显著高于对照组(P<0.05);肝硬化大鼠膈肌肌纤维断裂,溶解。结论肝硬化大鼠膈肌肌纤维结构受到破坏,收缩功能下降,可能与SOD,SDH,Na -K -ATPase,Ca2 -Mg2 ATPase活性降低,NOS活性和MDA含量增高有关。 相似文献