本文選題：POEMS綜合癥 + 臨床表現(xiàn)��； 參考：《浙江大學(xué)》2016年碩士論文

【摘要】：POEMS綜合癥是與漿細胞失調(diào)有關(guān)的臨床綜合癥,其臨床表現(xiàn)復(fù)雜,累及全身各個系統(tǒng)。為了引起臨床工作者對該疾病的重視并加深認識,本研究收集了本院2009年至今總共10例POEMS綜合癥病例,對其診治過程相關(guān)資料進行整理分析。發(fā)現(xiàn)所有確診患者均符合Dispenzieri等人2003年提出的診斷標(biāo)準,而且除了有多發(fā)性神經(jīng)病、器官腫大、血管外容量過負荷、內(nèi)分泌異常、皮膚改變、漿細胞增生、骨質(zhì)破壞等累及多系統(tǒng)的經(jīng)典臨床表現(xiàn)之外,還包括雷諾現(xiàn)象、口干多飲多尿、肺動脈高壓、腎功能不全、發(fā)熱等發(fā)生率相對較低的臨床表現(xiàn)。10例患者首診于9個不同科室,9種不同的最初診斷,3種不同的治療方法,未規(guī)范治療的患者死亡率高。因此POEMS綜合癥患者臨床表現(xiàn)非常復(fù)雜,非�？赡芤驗榕R床醫(yī)生的認識不足而引起誤診、漏診。延遲的和不規(guī)范的治療最終導(dǎo)致患者預(yù)后不良。各個�？漆t(yī)生在臨床工作中遇到類似累及多系統(tǒng)的臨床表現(xiàn)應(yīng)該警惕本病的可能。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R55

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