去纤苷治疗土三七致肝窦阻塞综合征1例

Defibrinin in treatment of hepatic sinusoidal obstruction syndrome caused by Gynura segetum:a case report

土三七所致肝窦阻塞综合征较常见,部分轻症患者可自愈,但对于重症患者尚缺乏有效的治疗方案。为提高对土三七所致肝窦阻塞综合征的认识,提高广大医务工作者对该病的诊疗水平,现将中南大学湘雅二医院收治的1例使用去纤苷成功治疗土三七所致肝窦阻塞综合征病例进行报道。本例患者在连续服用土三七1个月后出现腹胀腹痛,行肝脏MR增强+MRCP肝脏内可见明显“地图样”强化,肝窦阻塞综合征诊断明确,给予抗凝、改善循环、护肝、利尿治疗后疗效欠佳,加用去纤苷药物治疗后患者临床症状好转,复查肝脏MR增强+MRCP,肝内“地图样”强化消失。

Hepatic sinusoid obstruction syndrome(HSOS)caused by Gynura segetum is a common clinical condition.While some patients with mild disease could be self-limited,there is lack of effective treatment for severe HSOS.In order to improve the understanding of diagnosis and therapeutic level of HSOS caused by Gynura segetum,here a case of Gynura segetum-related HSOS successfully treated with Dfibrinin in Second Xiangya Hospital of Central South University was reported.The patient was admitted because of abdominal pain and distension after taking Gynura segetum continuously for 1 month.Enhanced liver MRI showed an obvious map-like enhancement,thus the diagnosis of HSOS was clear.The treatment method including anticoagulation,circulation improvement,liver protection and diuresis,however,the effectiveness was poor.The patient’s clinical symptoms improved after treatment with defibrinin drugs and a second test of enhanced liver MRI+MRCP proved a disappearance of the intrahepatic map-like enhancement.