肝门静脉积气3例并文献分析

目的 总结分析肝门静脉积气(hepatic portal venous gas,HPVG)的产生原因、诊断及治疗.方法 回顾菏泽市立医院2018年3月至2019年10月诊治的3例HPVG病例,结合国内报道的HPVG病例,总结分析HPVG的临床特点、诊治经过和预后.结果 本组3例HPVG中1例由腹腔感染引起,1例由肠坏死...

Hepatic portal venous gas:report of 3 cases and literature review

Objective To summarize and analyze the causes,diagnosis and treatment of hepatic portal vein gas(HPVG).Methods Clinical data of 3 cases with HPVG admitted to Heze Municipal Hospital from Mar.2018 to Oct.2019 were retrospectively reviewed.Combined with the published cases of HPVG in China,we summarized and analyzed the clinical characteristics,diagnosis,treatment and prognosis of HPVG.Results For the 3 cases of HPVG in our hospital:1 case was caused by abdominal infection,1 case was caused by intestinal necrosis and dilatation,and no exact infection focus was found in 1 case.One case was complicated with diabetes,and 1 case had no history of diabetes,but the blood glucose value was 33.3 mmol/L on admission.One case was cured and 2 cases died.Added into 49 cases reported in domestic literature,primary diseases of 37 cases were intestinal necrosis,intestinal obstruction,gastrointestinal perforation,gastric dilation,acute appendicitis and other gastrointestinal diseases,which accounted for 71.15%.Trauma,pancreatitis,bile duct stones,diabetes and other causes have also been reported.Of all 52 HPVG patients,25 were treated surgically and 27 were treated conservatively.The total mortality was 30.77%.Conclusion The most common causes of HPVG are acute gastrointestinal diseases.Trauma,pancreatitis,cholelithiasis and diabetes are also related to HPVG.Abdominal CT or ultrasound can be used to diagnose HPVG,and abdominal CT examination is the first choice to evaluate the absorption of HPVG.The primary disease and the individual’s physical condition are the main basis for deciding whether to perform surgical treatment.It is recommended to carry out culture of blood or infected tissues and select sensitive antibiotics for anti-inflammatory treatment.If there is no contraindication,aspirin or low molecular weight heparin calcium can be given to HPVG patients for prevention of thrombosis.