关于重症肝炎诊断及分型的探讨—60例临床与病理分析

Diagnosis and Typing of Severe Hepatitis-Clinicopathologic Analysis of 60 Cases

本文通过对56例重症肝炎及10例深度黄疸患者的临床及病理资料分析,表明急重肝和亚重肝的临床诊断与病理诊断符合率分别为50%及95.5%。10例无昏迷、腹水等临床症状的深度黄疸患者,肝活检诊断5例为亚急性肝坏死,5例为慢活肝。以上提示临床诊断重症肝炎有明显局限性,原因主要是与亚急性肝坏死者临床表现多样化有关。

Clinical and pathological analyses were carried on in 56 patients with severehepatitis and 10 with heavy jaundice.The coincidence rate of clinical and patholo-gical diagnosis was 50% in acute severe hepatitis,and 95.5% in subaeute severehepatitis.Among the 10 patients with profound jaundice without coma and ascites,5 were proved to be subaeute liver necrosis on liver biopsy examination,another 5patients were diagnosed pathologically with chronic active hepatitis.These observa-tions suggested the obvious limitation of clinical diagnosis in severe hepatitis,mainly due to the variability of clinical courses of subacute liver necrosis.Theclassification on subacute severe hepatitis was also discussed.