摘要
背景:肝性脊髓病是肝病晚期引起的脑脊髓损害,目前尚缺乏有效的治疗方法。肝移植可作为从病因上治疗该疾患的一种尝试,但有关肝移植治疗肝性脊髓病的远期疗效罕有报道。目的:进一步探讨肝移植对肝性脊髓病的远期疗效。方法:回顾性分析2002-08/2004-09于解放军第三○九医院行原位肝移植的2例肝性脊髓病患者临床资料。随访18,43个月,对肝移植后2例患者下肢肌力的恢复进行严密观察。结果与结论:两例患者肝移植后4周全身情况恢复良好,患者的临床症状、体征均获得明显改善,血常规及各项生化指标全部正常,移植肝功能正常。于移植后6周出院。患者1于移植后6个月可下床长时间站立,12个月手扶参照物缓慢行走,移植后43个月手无扶物可缓慢行走,下肢肌力4级;肝功能正常。患者2:移植后6个月双下肢可在床上移动,18个月手扶参照物可缓慢移动,下肢肌力3级;肝功能正常。说明肝脏移植可有效控制肝性脊髓病的发展并明显有利于双下肢肌力的恢复;肝移植对肝性脊髓病是一种新的、有效的治疗方法。但总结的肝移植治疗肝脊髓病例数较少,观察时间短,其疗效有待于进一步多方面评估。
BACKGROUND：Hepatic myelopathy results from liver disease,which lacks of effective cure method.Liver transplantation has attempted to cure this disease;however,the long-term therapeutic effect is rarely reported.OBJECTIVE：To explore the long-term therapeutic effect of liver transplantation in patients with hepatic myelopathy.METHODS：The clinical data of 2 patients with hepatic myelopathy,who underwent orthotopic liver transplantation,in August 2002 and November 2004,at the 309 Hospital of Chinese PLA,were analyzed retrospectively.The time of follow-up was 18 and 43 months,respectively.The muscle strength of double lower limbs in 2 patients was assessed prior to and after operation.RESULTS AND CONCLUSION：Two patients recovered well at 4 weeks after transplantation,the clinical symptom and physical signs of patients were improved obviously,the blood routine examination and other biochemical index were normal,and the function of transplanted kidney was normal.Two patients discharged at 6 weeks after transplantation.Patient 1 could stand for a long time at months 6 after transplantation,walked slowly with the supporter after 12 months and without the supporter at 43 months.The muscular strength of two lower limbs was grade 4.And the liver function was normal.Patients 2 could move his lower limbs in bed at months 6 after transplantation,walked with the supporter at 18 months.The muscular strength of two lower limbs was grade 3.The liver function was normal.It demonstrated that liver transplantation is beneficial to control hepatic myelopathy and recover muscular strength of two lower limbs.It is a newly developed,effective curing method for treating hepatic myelopathy.However,the numbers were small with short time observation,thus,the long-term therapeutic effect still need to be explored.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第18期3397-3400,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
