中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2014年
4期
315-316
,共2页
张日欣%梁锐%高振明%柳勤龙%王立明
張日訢%樑銳%高振明%柳勤龍%王立明
장일흔%량예%고진명%류근룡%왕립명
肝性脊髓病%肝移植
肝性脊髓病%肝移植
간성척수병%간이식
Hepatic myelopathy%Liver transplantation
肝性脊髓病是继发于终末期肝病的一种特殊类型的神经系统改变,是以脊髓病变为主要症状的综合征,多于自然形成的广泛的门体静脉侧支循环或门体静脉分流术后出现,临床比较罕见.该病预后不良,病情呈慢性进展.目前的治疗方法主要是针对原发肝病进行干预.外科医师为减少毒性物质的吸收行结肠游离手术或回肠直肠吻合术,短期内可降低血氨和改善神经症状,但长期效果不理想.2012年4月大连医科大学附属二医院收治l例肝性脊髓病患者.该例患者行肝移植术后临床症状、体征及生命质量均获得明显改善,双下肢肌力得到有效恢复.肝移植是从病因上治疗肝性脊髓病的有效方法.
肝性脊髓病是繼髮于終末期肝病的一種特殊類型的神經繫統改變,是以脊髓病變為主要癥狀的綜閤徵,多于自然形成的廣汎的門體靜脈側支循環或門體靜脈分流術後齣現,臨床比較罕見.該病預後不良,病情呈慢性進展.目前的治療方法主要是針對原髮肝病進行榦預.外科醫師為減少毒性物質的吸收行結腸遊離手術或迴腸直腸吻閤術,短期內可降低血氨和改善神經癥狀,但長期效果不理想.2012年4月大連醫科大學附屬二醫院收治l例肝性脊髓病患者.該例患者行肝移植術後臨床癥狀、體徵及生命質量均穫得明顯改善,雙下肢肌力得到有效恢複.肝移植是從病因上治療肝性脊髓病的有效方法.
간성척수병시계발우종말기간병적일충특수류형적신경계통개변,시이척수병변위주요증상적종합정,다우자연형성적엄범적문체정맥측지순배혹문체정맥분류술후출현,림상비교한견.해병예후불량,병정정만성진전.목전적치료방법주요시침대원발간병진행간예.외과의사위감소독성물질적흡수행결장유리수술혹회장직장문합술,단기내가강저혈안화개선신경증상,단장기효과불이상.2012년4월대련의과대학부속이의원수치l례간성척수병환자.해례환자행간이식술후림상증상、체정급생명질량균획득명현개선,쌍하지기력득도유효회복.간이식시종병인상치료간성척수병적유효방법.
Hepatic myelopathy is one of special category changes of nervous system,which was secondary to the end-stage hepatic diseases and is a syndrome of myeleterosis.It usually occurred after portosystemic shunt surgery or collateral circulation of portosystemic vein.The prognosis of hepatic myelopathy is poor,and the progression of this disease is slow.Surgical approaches such as dissociation of colon and anastomosis of ileum and rectum aimed at reducing the absorption of toxic substance and thus to breakdown the blood ammonia and improve the symptoms of nervous system,but the effects are not satisfactory.The clinical data of 1 patient with hepatic myelopathy who received liver transplantation at the Second Affiliated Hospital of Dalian Medical University in April 2012 were retrospectively analyzed.The clinical symptoms and physical signs were improved,and muscle strength was effectively recovered in the patient.Liver transplantation might be an effective method for the treatment of hepatic myelopathy.