慢性淤胆型肝炎患者高压氧治疗前后肝血流临床症状肝功能肝组织结构的变化

目的:观察慢性淤胆型肝炎(CCH)高压氧(HBO)治疗前后患者的肝血流、临床症状、肝功能、肝组织学结构变化。方法:用纯氧单仓治疗(2.5 MPa,2 h/d,10 d/cyc,6 cyc)30例CCH。治疗前后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;肝穿刺活检病理观察。取算术均数行t检验。结果:治疗后肝血流图收缩波和肝门静脉右支血流量明显升高;患者临床症状和肝功能明显改善;治疗前后二次肝穿活检的10例的患者中,9例毛细胆管淤胆和肝细胞淤胆减轻;7例患者肝细胞变性坏死、汇管区炎症减轻(P<0.05)。3例肝间质纤维化程度减轻(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脏功能,有效地减轻肝细胞、毛细胆管淤胆和肝组织学结构的损伤。

Changes in the Hepatic Blood Flow, Function, Tissue Structure, and the Clinical Symptoms of Patients with Chronic Cholestasis Hepatitis Treated with Hyperbaric Oxygenation

Purpose: To observe the changes in the hepatic blood flow function tissue structure, and the clinical symptoms of patients with chronic cholestasis hepatitis (CCH) treated with hyperbaric oxygena-tion (HBO). Methods: 30 CCH were treated with the HBO (2.5 MPa, 2 h/d, 10 d/cyc, 6 eyc). Before and after the HBO treatment, the contractive wave of hepatic blood-flow graph and blood flow of right potal vein were tested, using the hepatic rheometer doppler B-mode ultrasound equipment. The hepatic func-tion, clinical symptoms and structure of hepatic tissue were determined. Results: After the HBO treat-ment, the contractive wave of hepatic blood-flow graph, blood-flow of right portal vein were increased, the hepatic function and the clinical symptoms were improved. Of 10 CCH patients performed by two liver biopsy, cholestasis in the liver cell and canaliculars were reduced after the HBO treatment in 9 patients were reduced in 7 patients. Liver cell degeneration, necrosis and portal area inflammation were also reduced in 3 cases (P<0.05). Liver fibrinoid regeneration (P>0.05). Conclusion: HBO has good therapeutic effects to the patients with CCH by increasing the blood flow of right portal vein and hepatic arteries, improving the hepatic function and the clinical symptoms, and reducing the liver cholestasis and tissue structure in-juries.