中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2015年
4期
213-216
,共4页
潘宜鹏%范宁%臧运金%张斌%张顺%李志强%付晓悦%王建红%许传屾
潘宜鵬%範寧%臧運金%張斌%張順%李誌彊%付曉悅%王建紅%許傳屾
반의붕%범저%장운금%장빈%장순%리지강%부효열%왕건홍%허전신
肝移植%肝性脊髓病%疗效评价
肝移植%肝性脊髓病%療效評價
간이식%간성척수병%료효평개
Liver transplantation%Hepatic myelopathy%Therapeutic efficiency
目的 探讨肝移植对改善终末期肝病患者肝性脊髓病(HM)症状的效果.方法 回顾性分析17例接受肝移植手术的终末期肝病合并HM患者的临床资料.随访期限为50个月(13～106个月).对肝移植前后患者的双下肢肌力、血常规和生化指标以及双下肢活动情况进行分析.结果 肝移植术后8周内,所有患者的血常规、生化指标等均基本恢复正常.术后4周内血氨均恢复正常,平均值为44.1μmol/L.截至随访期末,17例患者的双下肢肌力均有改善,其中15例肌力恢复正常,2例肌力恢复也超过2个级别,其中由Ⅳ级恢复到Ⅴ级3例(17.6％),由Ⅲ级恢复到Ⅴ级8例(47.1％),由Ⅱ级恢复到Ⅴ级4例(23.5％),由工级恢复到Ⅳ级1例(5.9％),由Ⅰ级恢复到Ⅲ级1例(5.9％).术前9例无法站立的患者中,术后1例能恢复自主行走,7例恢复到辅助行走,1例仍无法站立,但肌力由Ⅰ级恢复到Ⅲ级;术前2例可站立的患者术后均恢复到辅助行走;术前3例辅助行走的患者术后均恢复到自主行走;3例自主行走肌力也完全恢复正常.结论 终末期肝病合并HM患者在肝移植术后远期,HM症状得到明显改善.HM的预后与其术前本身的进展程度有关,在出现下肢活动异常前接受肝移植治疗的患者,其HM预后较好.
目的 探討肝移植對改善終末期肝病患者肝性脊髓病(HM)癥狀的效果.方法 迴顧性分析17例接受肝移植手術的終末期肝病閤併HM患者的臨床資料.隨訪期限為50箇月(13～106箇月).對肝移植前後患者的雙下肢肌力、血常規和生化指標以及雙下肢活動情況進行分析.結果 肝移植術後8週內,所有患者的血常規、生化指標等均基本恢複正常.術後4週內血氨均恢複正常,平均值為44.1μmol/L.截至隨訪期末,17例患者的雙下肢肌力均有改善,其中15例肌力恢複正常,2例肌力恢複也超過2箇級彆,其中由Ⅳ級恢複到Ⅴ級3例(17.6％),由Ⅲ級恢複到Ⅴ級8例(47.1％),由Ⅱ級恢複到Ⅴ級4例(23.5％),由工級恢複到Ⅳ級1例(5.9％),由Ⅰ級恢複到Ⅲ級1例(5.9％).術前9例無法站立的患者中,術後1例能恢複自主行走,7例恢複到輔助行走,1例仍無法站立,但肌力由Ⅰ級恢複到Ⅲ級;術前2例可站立的患者術後均恢複到輔助行走;術前3例輔助行走的患者術後均恢複到自主行走;3例自主行走肌力也完全恢複正常.結論 終末期肝病閤併HM患者在肝移植術後遠期,HM癥狀得到明顯改善.HM的預後與其術前本身的進展程度有關,在齣現下肢活動異常前接受肝移植治療的患者,其HM預後較好.
목적 탐토간이식대개선종말기간병환자간성척수병(HM)증상적효과.방법 회고성분석17례접수간이식수술적종말기간병합병HM환자적림상자료.수방기한위50개월(13～106개월).대간이식전후환자적쌍하지기력、혈상규화생화지표이급쌍하지활동정황진행분석.결과 간이식술후8주내,소유환자적혈상규、생화지표등균기본회복정상.술후4주내혈안균회복정상,평균치위44.1μmol/L.절지수방기말,17례환자적쌍하지기력균유개선,기중15례기력회복정상,2례기력회복야초과2개급별,기중유Ⅳ급회복도Ⅴ급3례(17.6％),유Ⅲ급회복도Ⅴ급8례(47.1％),유Ⅱ급회복도Ⅴ급4례(23.5％),유공급회복도Ⅳ급1례(5.9％),유Ⅰ급회복도Ⅲ급1례(5.9％).술전9례무법참립적환자중,술후1례능회복자주행주,7례회복도보조행주,1례잉무법참립,단기력유Ⅰ급회복도Ⅲ급;술전2례가참립적환자술후균회복도보조행주;술전3례보조행주적환자술후균회복도자주행주;3례자주행주기력야완전회복정상.결론 종말기간병합병HM환자재간이식술후원기,HM증상득도명현개선.HM적예후여기술전본신적진전정도유관,재출현하지활동이상전접수간이식치료적환자,기HM예후교호.
Objective To investigate the long-term efficacy of orthotopic liver transplantation (OLT) in patients with hepatic myelopathy (HM).Method The clinical data of 17 patients with hepatic myelopathy,who underwent OLT,were retrospectively analyzed.The follow-up period was 13-106 months (mean 50 months).The muscle strength of two lower limbs,the blood routine examinations and other biochemical indexes,and the ability to walk were assessed before and after operation.Result The blood routine examination and other biochemical indexes were normal at 8th weeks after OLT.The muscle strength of two lower limbs was increased after OLT.Fourteen cases recovered completely.As to the ability to walk,it was greatly different among patients.Seven patients could walk independently and 9 patients could walk with help.Only 1 could not stand so far.Conclusion The efficiency of liver transplantation in patients with HM should be affirmed.The prognosis of HM is related to conditions of patients before operation,and OLT was an effective way for treatment of patients with HM before paralysis.
