中国人肠系膜脂膜炎的临床特点分析344例

Clinical characteristics of Chinese patients with mesenteric panniculitis:Analysis of 344 cases

目的:通过对肠系膜脂膜炎患病情况的分析,了解中国人肠系膜脂膜炎患者的临床特点,以提高外科医师对该病的认识和诊治水平.方法:利用近30年来文献报道的342例及北京市石景山医院确诊的2例肠系膜脂膜炎患者的临床资料,总结其在性别、发病年龄、临床表现、伴随疾病、诊断及治疗方面的特点.结果:肠系膜脂膜炎患者中男性较女性稍多(1.21∶1),平均发病年龄是55.4岁,患者以腹痛为最主要的临床表现,占就诊原因的62.6%,患者常有一些伴随疾病,其中有13.4%的患者伴发恶性肿瘤.34.3%的患者靠病理确诊,其余患者靠CT及临床症状诊断,CT检查结果显示76.0%的患者有完整或不完整的假包膜存在,66.3%的患者在肠系膜血管周围可见"脂肪环"征.72例患者进行了手术治疗,术后84.7%的患者症状明显缓解.结论:肠系膜脂膜炎缺乏特异性的临床表现,极易被误诊,但本病的预后良好.提高对该病临床表现和影像学的认识及病理检查是提高确诊率的关键.

AIM：To summarize the clinical characteristics of mesenteric panniculitis patients in China by investigating their sickness status.METHODS：The clinical data for 342 cases of mesenteric panniculitis reported in medical journals in recent 30 years and two cases diagnosed in Beijing Shijingshan Hospital were analyzed to summarize the characteristics of mesenteric panniculitis patients with respect to sex,age of onset,clinical features,accompanying disease,diagnosis and treatment.RESULTS：There were more male mesenteric panniculitis patients than female ones（1.21：1）.The average age of the patients was 55.4 years.The principal symptom of mesenteric panniculitis was abdominal pain,with 62.6%of the cases presenting with this symptom.The patients often suffered from some accompanying diseases,and 13.4%of them were complicated with malignancy.Approximately 34.3%of the cases were pathologically diagnosed,and the rest were diagnosed by CT scan and clinical symptoms.CT examination results showed that 76.0%of the patients had complete or incomplete false capsule and 66.3%of the patients had ＂fat ring＂ around mesenteric vessels.Of 72 patients who underwent surgical treatment,84.7%showed an obvious relief of symptoms.CONCLUSION：Mesenteric panniculitis lacks typical clinical manifestations and is easy to be misdiagnosed,but it has a favorable prognosis.Enhanced awareness of its clinical manifestations and a better understanding of imaging and pathological examination are the key to increasing the final diagnosis rate.