门体静脉分流术后痉挛性轻截瘫

Spastic paraparcsis following portal systemic shunting

在慢性肝病病人中，因自发或手术所致门体静脉分流而可引起一种称为门体静脉分流性脊髓病的极为罕见的并发症。本文报告一例４９岁男性病人，有慢性肝病史，在门体静脉分流后四个月出现双下肢进行性瘫痪。起病隐袭，神经系统体征包括轻截瘫，腱反射亢进及病理征阳性。感觉及直肠膀胱功能正常。实验室发现包括肝功能异常、ＥＥＧ双额区慢波。血氨则在正常范围内。对门体静脉分流性脊髓病的发病机理、病理、临床表现、实验特征。

In patients with chronic liver disease, spontaneous or surgical portal systemic shunting can cause a rare complication called portal systemic myelopathy. We reported a case of progressive spastic paraparesis in a 49 year old man with surgical portal systemic shunting which developed due to chronic liver disease, It developed insidiously in about 4 months following surgical shunting. Neurological signs included spastic paraparesis, hyperflexia, exensor plantar response. amd normal sensory, bladdder and bowel function. Laboratory findings consisted of abnormal liver function, bilateral frontal slow waves and a normal blood ammonia concentration, The pathogenesis pathology, clinical and laboratory features, dignosis and treatment of this disorder are discussed.