不明原因肝功能异常患者的临床诊断思维

目的：建立不明原因肝功能异常患者的临床诊断思维以提高疑难肝病的诊治水平。方法：回顾性分析我院收治的4例不明原因肝功能异常患者的临床资料及诊治经过,并复习相关文献。结果：导致肝功能异常的病因虽极为复杂但通过详细询问病史,进行细致全面的体格检查以及必要的实验室和辅助检查,慎重采取诊断性治疗措施,提高少见病例对诊断影响的认识,绝大多数的病因可以查明。结论：不明原因肝功能异常患者的临床表现多样,病因复杂,建立相应的临床诊断思维可减少误诊和漏诊。

Clinical Diagnosis Thinking of Patients with Liver Dysfunction of Unknown Etiology

Objective： To draw up the clinical diagnosis thinking of patients with liver dysfunction of unknown etiology and to improve the level of diagnosis and therapy. Methods： Clinical data of 4 patients with liver dysfunction of unknown etiology were retrospectively analyzed and related literatures were reviewed. Results： The cause of abnormal liver fimction is very complex but the vast majority of etiology can find out with detailed medical history enquiry, meticulous and overall physical examination as well as the necessary laboratory and auxiliary examinations, careful takeing diagnostic treatment measures, improving the rare cases in the understanding of the diagnosis. Conclusions： Due to the various clinical manifestations and complex causes of the patients with liver dysfimction of unknown etiology, we should establish corresponding clinical diagnosis thinking to reduce the misdiagnoses and missed diagnoses.