10例POEMS综合症患者临床分析

发布时间：2018-05-06 03:00

本文选题：POEMS综合症 + 临床表现　；参考：《浙江大学》2016年硕士论文

【摘要】：POEMS综合症是与浆细胞失调有关的临床综合症,其临床表现复杂,累及全身各个系统。为了引起临床工作者对该疾病的重视并加深认识,本研究收集了本院2009年至今总共10例POEMS综合症病例,对其诊治过程相关资料进行整理分析。发现所有确诊患者均符合Dispenzieri等人2003年提出的诊断标准,而且除了有多发性神经病、器官肿大、血管外容量过负荷、内分泌异常、皮肤改变、浆细胞增生、骨质破坏等累及多系统的经典临床表现之外,还包括雷诺现象、口干多饮多尿、肺动脉高压、肾功能不全、发热等发生率相对较低的临床表现。10例患者首诊于9个不同科室,9种不同的最初诊断,3种不同的治疗方法,未规范治疗的患者死亡率高。因此POEMS综合症患者临床表现非常复杂,非常可能因为临床医生的认识不足而引起误诊、漏诊。延迟的和不规范的治疗最终导致患者预后不良。各个专科医生在临床工作中遇到类似累及多系统的临床表现应该警惕本病的可能。
[Abstract]:POEMS syndrome is a clinical syndrome associated with plasma cell disorder. In order to arouse the attention of clinical workers and deepen understanding of the disease, this study collected a total of 10 cases of POEMS syndrome in our hospital from 2009 to now, and analyzed the relevant data of their diagnosis and treatment process. In addition to polyneuropathy, organ enlargement, extravascular volume overload, endocrine abnormalities, skin changes and plasma cell proliferation, we found that all the confirmed patients were in accordance with the diagnostic criteria proposed by Dispenzieri et al in 2003, and had polyneuropathy, organ enlargement, extravascular volume overload, endocrine abnormalities, skin changes, and plasma cell proliferation. In addition to the classic clinical manifestations involving multiple systems, such as bone destruction, the Renault phenomenon, dry mouth and polyuria, pulmonary hypertension, renal insufficiency, 10 patients with relatively low incidence of fever were first diagnosed in 9 different departments, 9 different initial diagnoses and 3 different treatments. The mortality rate of the patients without standard treatment was high. Therefore, the clinical manifestations of POEMS syndrome patients are very complicated, which may lead to misdiagnosis and missed diagnosis due to the lack of knowledge of clinicians. Delayed and irregular treatment ultimately leads to poor prognosis. Doctors should be alert to the possibility of multiple-system involvement in their clinical work.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R55

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