我院于2004年及2006年分别出现了重度子痫前期剖宫产术后并发腹壁巨大血肿病例2例,现报道如下。1病历摘要例1：女,25岁。孕2产0,因停经8个月余,发现蛋白尿,血压高半个月于2004-06-06入院。查体BP 140/100 mm Hg,眼睑轻水肿,双下肢水肿...我院于2004年及2006年分别出现了重度子痫前期剖宫产术后并发腹壁巨大血肿病例2例,现报道如下。1病历摘要例1：女,25岁。孕2产0,因停经8个月余,发现蛋白尿,血压高半个月于2004-06-06入院。查体BP 140/100 mm Hg,眼睑轻水肿,双下肢水肿Ⅱ度。其他无异常。产科情况宫高30cm,腹围92 cm,胎心音150次/min,左枕前位。展开更多
AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This...AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This was a retrospective cohort study of 216 consecutive liver transplant patients who survived for 〉 6 mo after transplantation; 169 received a liver transplant from a living donor and 47 from a cadaveric donor. The platelet counts or spleen volumes were examined before transplant, i, 6, and 12 mo after transplant, and then annually until 5 years after transplant. RESULTS： The mean follow-up period was 49 mo （range, 21-66）. Platelet counts increased continuously for 5 years after orthotopic liver transplant. The restoration of platelet counts after transplant was significantly slower in patients with severe pretransplant thrombocytopenia （〈 50000/μL） until 4 years after transplant （P = 0.005）. Donor type did not significantlyaffect the recovery of platelet count and spleen volume in either patient group. In multivariate analysis, pretransplant severe thrombocytopenia （〈 50000/μL） was an independent factor associated with sustained thrombocytopenia （P 〈 0.001, odds ratio 6.314; confidence interval, 2.828-14.095）. Thrombocytopenia reappeared after transplant in seven patients with portal flow disturbance near the anastomosis site. CONCLUSION： Our study suggests that severe thrombocytopenia before transplant is closely associated with delayed recovery of platelet count after transplant and donor type did not affect the recovery of thrombocytopenia. The reappearance of thrombocytopenia after transplant should be considered a possible indicator of flow disturbance in the portal vein.展开更多
An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy.Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas...An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy.Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare.We herein,present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis,and review the literature on muscle hematoma associated with cirrhosis.A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemia.The cause of anemia could not be detected,and the patient was treated conservatively. The site of bleeding was not detected with either gastroduodenal endoscopy or upper abdominal computed tomography,the latter of which did not include the iliopsoas muscle.He died on the 10th day of admission and bilateral iliopsoas hematomas were found on autopsy.An iron stain was positive in the iliopsoas muscle.Eight cases of muscle hematoma associated with cirrhosis,including the present case, were found in a review of the literature.Four of these cases involved the rectus abdominis muscle,3 involved the iliopsoas muscle and 1 involved combined muscles.Alcoholic cirrhosis accounted for 75%of the cases.One case(12.5%)was associated with virus- related cirrhosis,and another with combined virus- and alcohol-related cirrhosis.The mortality rate was 75%despite early diagnosis and low risk scores for cirrhosis.Muscle hematoma in patients with cirrhosis isclosely related to alcoholism,and the mortality rate of the condition is extremely high.In conclusion,muscle hematoma should be recognized as an important complication of cirrhosis.展开更多
文摘我院于2004年及2006年分别出现了重度子痫前期剖宫产术后并发腹壁巨大血肿病例2例,现报道如下。1病历摘要例1：女,25岁。孕2产0,因停经8个月余,发现蛋白尿,血压高半个月于2004-06-06入院。查体BP 140/100 mm Hg,眼睑轻水肿,双下肢水肿Ⅱ度。其他无异常。产科情况宫高30cm,腹围92 cm,胎心音150次/min,左枕前位。
基金The Grant (Clinical Research Center of Liver Cirrhosis) of the Korea Health 21 Research and Development Project from Ministry of Health and Welfare, Republic of Korea, No. A050021
文摘AIM： To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS： This was a retrospective cohort study of 216 consecutive liver transplant patients who survived for 〉 6 mo after transplantation; 169 received a liver transplant from a living donor and 47 from a cadaveric donor. The platelet counts or spleen volumes were examined before transplant, i, 6, and 12 mo after transplant, and then annually until 5 years after transplant. RESULTS： The mean follow-up period was 49 mo （range, 21-66）. Platelet counts increased continuously for 5 years after orthotopic liver transplant. The restoration of platelet counts after transplant was significantly slower in patients with severe pretransplant thrombocytopenia （〈 50000/μL） until 4 years after transplant （P = 0.005）. Donor type did not significantlyaffect the recovery of platelet count and spleen volume in either patient group. In multivariate analysis, pretransplant severe thrombocytopenia （〈 50000/μL） was an independent factor associated with sustained thrombocytopenia （P 〈 0.001, odds ratio 6.314; confidence interval, 2.828-14.095）. Thrombocytopenia reappeared after transplant in seven patients with portal flow disturbance near the anastomosis site. CONCLUSION： Our study suggests that severe thrombocytopenia before transplant is closely associated with delayed recovery of platelet count after transplant and donor type did not affect the recovery of thrombocytopenia. The reappearance of thrombocytopenia after transplant should be considered a possible indicator of flow disturbance in the portal vein.
文摘An iliopsoas hematoma can occur either spontaneously or secondary to trauma or bleeding tendency due to hemophilia and anticoagulant therapy.Although liver cirrhosis is commonly associated with coagulopathy, iliopsoas hematoma is very rare.We herein,present a case of bilateral iliopsoas hematoma in a patient with alcoholic cirrhosis,and review the literature on muscle hematoma associated with cirrhosis.A 56-year-old man with alcoholic cirrhosis was admitted in a state of shock with anemia.The cause of anemia could not be detected,and the patient was treated conservatively. The site of bleeding was not detected with either gastroduodenal endoscopy or upper abdominal computed tomography,the latter of which did not include the iliopsoas muscle.He died on the 10th day of admission and bilateral iliopsoas hematomas were found on autopsy.An iron stain was positive in the iliopsoas muscle.Eight cases of muscle hematoma associated with cirrhosis,including the present case, were found in a review of the literature.Four of these cases involved the rectus abdominis muscle,3 involved the iliopsoas muscle and 1 involved combined muscles.Alcoholic cirrhosis accounted for 75%of the cases.One case(12.5%)was associated with virus- related cirrhosis,and another with combined virus- and alcohol-related cirrhosis.The mortality rate was 75%despite early diagnosis and low risk scores for cirrhosis.Muscle hematoma in patients with cirrhosis isclosely related to alcoholism,and the mortality rate of the condition is extremely high.In conclusion,muscle hematoma should be recognized as an important complication of cirrhosis.
