肝性脊髓病临床分析

Clinical research of hepatic myelopathy: analysis of 30 cases

目的:探讨肝性脊髓病(HM)的临床特点及治疗方法。方法:对30例确诊HM患者的临床资料进行回顾性分析。结果:30例患者均具有典型的痉挛性截瘫的临床表现;4例(13.3%)曾接受门腔静脉分流术;28例(93.3%)血氨轻中度增高,血氨检测正常者2例(6.6%);28例(93.3%)内科治疗无明显效果。结论:HM患者以痉挛性截瘫为主要表现,血氨增高可能不是惟一致病因素,常规内科治疗效果不佳,肝移植为HM的治疗带来希望。

Objective： To analyze the clinical features of hepatic myelopathy（HM）, and to explore the possible treatment measures for HM patients, Methods： Clinical data of 30 definite HM patients were analyzed retrospectively. Results： All the 30 HM patients（ 100% ） had typical clinical fealures of spastic paraplegia（SP） but without sensory dysfunction, 4 of 30 cases （13.3%）received portacaval shunt（PCS）, The blood ammonia level of 2 cases（6.6%）was normal and was slightly or moderately increased（98 ～ 130μmol/L） in another 28 patients（93. 3% ）. All the 30 HM patients received medicine treatment, there was no signifieant effect in 28 cases （93.3%）, Conclusion： HM is characterized clinically by SP without sensory involvement. The increased blood ammonia level is not the only cause and routine medicine treatment is proved to be unefficient. Liver transplantation may afford promise of the treatment of HM patients.