高压氧治疗慢性淤胆型肝炎的临床和超微病理研究

目的:观察高压氧(HBO) 治疗慢性淤胆型肝炎(CCH) 前后患者的临床症状、肝功能、肝血流及肝组织超微结构变化。方法:用纯氧单仓治疗30 例CCH(2.5 MPa,2 h·d1 ,10 d 为1 个疗程,共6 个疗程),治疗前后用肝血流图仪和多普勒B超测定肝血流图收缩波和门静脉右支血流量;肝穿刺取新鲜肝组织,常规透射电镜病理观察,取算术均数行t 检验。结果:治疗后患者的临床症状及肝功能明显改善,肝血流图收缩波和肝门静脉右支血流量明显升高。肝细胞和毛细胆管淤胆减轻,肝细胞线粒体肿胀和kuffer 细胞增生减轻,溶酶体数量减少,汇管区淋巴细胞浸润和毛细血管增生明显,治疗前后差异显著( P<0.05) ;肝细胞内质网增生、高尔基体扩张、贮脂细胞增生减轻,间质纤维增生减轻,治疗前后差异不显著( P>0 .05) 。结论:HBO治疗CCH,可增加肝动脉及门静脉右支血流量,改善患者临床症状和肝功能,有效地减轻肝细胞和毛细胆管淤胆及肝组织超微结构的损伤

Clinical and Ultra Pathologic Study on the Changes in Patients with Chronic Cholestasis Hepatitis Treated with Hyperbaric Oxygenation

Objective:The work was designed to observe the changes in hepatic blood flow,function,tissue ultrastructures of patients with chronic cholestasis hepatitis(CCH) treated with hyperbaric oxygenation(HBO).Methods:30 patients who were collected randomly,were treated with the HBO.The dosage of HBO was 2.5 MPa,2 hours a day,10 days for one therapeutic course,with 2 days rest,altogether 6 courses.Before and after the HBO treatment,the contractive wave in hepatotachgram and the blood flow of right potal vein were tested.The liver biopsy was done altra pathologically.The mathematical average was taken from all the parameters obtained and analyzed statistically by t test.Results:After the HBO treatment,the contractive wave in hepatotachogram and the blood flow of right portal vein were incresed,the hepatic function and the clinical symptom were improved the cholestasis in liver cell and cholangiole,liver cell mitochondria swelling and lysosome numbers were reduced but the lymphocyte infiltration and capilary regeneration were increased remarkably.There was no difference between the parameters on endoplastic reticulum,Golgi complex,regeneration of lipocytes and interstitial cells before and after treatment.Conclusion:HBO has good therapeutic effects in increasing the blood flow of right portal vein and hepatic arteries,improving the hepatic function and the clinical syptoms,and reducing the liver cholestasis and ultrastructural injuries for the patients with chronic cholestasis hepatitis.