Clinical characteristic of hepatic sinusoidal obstruction syndrome in 2410 patients:a systematic analysis
Objective To analyze and summarize the clinical features,diagnosis and treatment of 2410 patients with hepatic sinusoidal obstruction syndrome(HSOS).Methods Chinese and foreign literatures published from Jan.1980 to Aug.2022 were retrieved from CNKI,WanFang and VIP databases.A total of 2410 HSOS patients and 150 published papers were enrolled.The gender,age,etiology,clinical manifestations,laboratory results,imaging find-ings,pathological features,treatment conditions and prognosis of HSOS patients were analyzed and summarized.Results The main etiology of 2410 HSOS patients was related to the consumption of plants,foods and various drugs containing pyrrolidine alkaloids(PAs)such as Tusanqi.The most common clinical manifestations were abdominal distension(78.09%),ascites(45.61%),abdominal pain(24.78%),hepatomegaly(26.14%)and jaundice(30.77%).The typical imaging manifestations were hepatomegaly.The liver was not uniformly enhanced and the enhancement was ″map-like″ or patchy.Hepatic vein display was not clear or not,and the inferior vena cava was compressed stenosis.In labo-ratory examination,AST,ALT,GGT and TBIL levels were mainly to moderately elevated,ALB and PLT decreased.Treatments of HSOS include conservative medical treatment,anticoagulation with low molecular weight heparin or warfa-rin,TIPS shunt surgery and liver transplantation.Conclusion HSOS tends to males.The etiology of HSOS is mainly the use of Tusanqi,often show abdominal distension,abdominal pain,ascites and hepatomegaly,and other prominent clinical manifestations.Laboratory examination and imaging examination can assist in the diagnosis,the treatment of HSOS is mainly symptomatic,anticoagulation,TIPS and liver transplantation.What's more,most patients have a good prognosis.
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