一例猫肝外门静脉短路的诊治

Diagnosis and Treatment of Extrahepatic Portosystemic Shunts in a Cat

通过临床基本检查、血液学、超声、计算机断层扫描(CT)等诊断方式检查1只患有肝性脑病症状的1.5岁病猫;其血液检查显示,血氨浓度596μmol/L,胆汁酸浓度在禁食12h后(空腹)及进食2h后分别为7μmol/L与36μmol/L。CT检查提示,胃左静脉-后腔静脉短路。经内科保守治疗和血管夹闭锁短路血管术相结合的治疗方式治愈。该治疗过程提示,门脉短路(PSS)可通过血氨、胆汁酸等血液学异常指标以及CT为主的影像学诊断确诊,经短路血管闭锁术可达到较好的治疗效果,可以广泛用于临床实践。

With the method of clinical basic examination,blood examination,ultrasonic examination and computed tomography,a 1.5-year-old cat with symptoms of hepatic encephalopathy was detected in detail.It was showed that the blood ammonia concentration was 596μmol/L,the bile acid concentration was 7μmol/L and 36μmol/L after fasting for 12 hand feeding for 2 h,and extrahepatic left gastric vein-after vena cava shunt was found with computed tomography.It was cured by conservative treatment of the vascular clipping surgery combined with internal medicine.It is suggested that the case with portosystemic shunts can be diagnosed by abnormal hematological indexes such as blood ammonia,bile acid and CT-based imaging diagnosis,in the meanwhile,the better therapeutic effect can be achieved by the vascular clipping surgery,which can be widely used in clinical practice.