肝门静脉气体25例临床特点分析。

IF 1.6 4区 医学 Q2 SURGERY
Frontiers in Surgery Pub Date : 2025-08-20 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1619587
Changhui Ji, Lihong Zhang, Zhirong Cheng, Zhilong Jiang, Tao Ji, Bo Ye
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引用次数: 0

摘要

目的:分析老年合并多种合并症患者肝门静脉气体(HPVG)的临床特点、病因分布及治疗结果,并评价早期手术干预对患者生存率的影响。方法:对2010年1月至2024年6月扬州大学泰兴人民医院收治的HPVG患者25例进行回顾性研究。该研究包括人口统计学特征、症状、合并症、病因、实验室和腹部CT结果、治疗和结果。结果:男女比例为2.6:1,中位年龄62岁。常见症状包括腹痛(88%)、呕吐(44%)和感染性休克(36%)。合并症包括冠心病(52%)、2型糖尿病(64%)和高血压(76%)。84%的患者出现白细胞增多。腹部CT扫描均显示HPVG。病因包括肠缺血/坏死(56%)、肠梗阻(24%)、疑似肠穿孔(12%)和肠道炎症(8%)。72%的患者采用紧急手术联合抗生素治疗,28%的患者采用保守治疗。结果显示有效率为60%,死亡率为40%。手术组痊愈12例,死亡6例;保守组3例康复,4例死亡。结论:HPVG病因复杂,腹部CT是推荐的诊断方法。急腹症患者应尽早手术治疗,以改善预后,但部分病例预后较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical characteristic analysis of 25 cases of hepatic portal venous gas.

Clinical characteristic analysis of 25 cases of hepatic portal venous gas.

Objective: To analyze the clinical characteristics, etiological distribution, and treatment outcomes of Hepatic Portal Venous Gas (HPVG) in a cohort of elderly patients with multiple comorbidities, and to evaluate the impact of early surgical intervention on survival rates.

Methods: A retrospective study was conducted on 25 patients with HPVG admitted to Taixing People's Hospital of Yangzhou University from January 2010 to June 2024. The study included demographic characteristics, symptoms, comorbidities, etiology, laboratory and abdominal CT results, treatment, and outcomes.

Results: The male-to-female ratio was 2.6:1, with a median age of 62 years. Common symptoms included abdominal pain (88%), vomiting (44%), and septic shock (36%). Comorbidities included coronary heart disease (52%), type 2 diabetes (64%), and hypertension (76%). Leukocytosis was observed in 84% of patients. Abdominal CT scans revealed HPVG in all patients. Etiologies included intestinal ischemia/necrosis (56%), intestinal obstruction (24%), suspected intestinal perforation (12%), and intestinal inflammation (8%). Treatment involved emergency surgery combined with antibiotic therapy in 72% of patients and conservative management in 28%. Outcomes showed 60% effectiveness and 40% mortality. Among the surgical group, 12 patients recovered and 6 died; among the conservative group, 3 recovered and 4 died.

Conclusion: HPVG has complex etiologies, and abdominal CT is the recommended diagnostic method. Patients with acute abdomen should undergo surgery as soon as possible to improve prognosis, although some cases have poor prognosis.

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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
期刊介绍: Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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