以肝功能衰竭为首要临床表现的恶性肿瘤肝脏浸润的临床特点分析:单中心9例回顾性研究
Clinical features of malignant tumor liver infiltration with liver failure as initial clinical manifestation: a single-center retrospective analysis of 9 cases
目的 总结由肿瘤弥漫性肝浸润引起的肝功能衰竭患者的临床特点. 方法 回顾性分析2009年7月到2015年12月收治的1 008例肝功能衰竭患者的临床资料,其中有9例为恶性肿瘤肝转移导致急性肝功能衰竭患者,观察其临床表现、实验室指标、临床进程和转归,总结其临床特点.结果 此类患者表现为肝脏肿大和快速临床进展,影像学提示下腔静脉呈现外压式狭窄,易误诊为布加综合征,预后差,病死率高达100%. 结论 伴随肝脏肿大、不明原因的肝功能衰竭的患者应考虑到恶性肿瘤肝浸润的可能性.治疗时应在肝功能恶化之前,尽早行肝穿刺明确诊断,以利于原发肿瘤的针对性治疗.
更多Objective To investigate the clinical features of patients with liver failure caused by tumor diffuse liver infiltration.Methods A retrospective analysis was performed for the clinical data of 1008 patients with liver failure who were admitted to our hospital from July 2009 to December 2015.Among these patients,9 had acute liver failure caused by liver metastasis of malignant tumor.Their clinical manifestations,laboratory markers,clinical progress,and outcome were observed,and the clinical features were summarized.Results Such patients were manifested as liver enlargement and rapid clinical progression,and imaging examination showed stenosis due to extemal compression in the inferior vena cava.The patients might be easily misdiagnosed with Budd-Chiari syndrome and had a poor prognosis,with a mortality rate as high as 100%.Conclusion As for the liver failure patients with unexplained liver enlargement,the possibility of liver metastasis of malignant tumors should be considered.Liver biopsy should be performed as early as possible before the deterioration of liver function,in order to facilitate the targeted therapy for the primary tumor.
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