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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·d1 ,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kuffer 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
Objective: To observe the clinical symptoms, liver function, hepatic blood flow and ultrastructure of liver in patients with chronic cholestatic hepatitis (CCH) treated with HBO. Methods: 30 cases of CCH (2.5 MPa, 2 h · d-1 for 10 days) were treated with pure oxygen in a single warehouse for 6 courses. Before and after treatment, hepatic blood flow chart instrument and Doppler ultrasonography Liver blood flow contraction wave and right portal vein blood flow; liver puncture take fresh liver tissue, conventional transmission electron microscopy pathological observation, take arithmetic mean t test. Results: After treatment, the clinical symptoms and liver function of patients were significantly improved. Contraction wave of hepatic blood flow diagram and right branch of hepatic portal vein blood flow increased significantly. Liver cells and bile duct cholestasis alleviate, hepatocyte mitochondria swelling and kuf fer cell proliferation reduced, the number of lysosomes reduced, portal area lymphocyte infiltration and capillary proliferation significantly, before and after treatment significant difference (P <0.05); liver cells Endoplasmic reticulum hyperplasia, Golgi apparatus dilatation, reduction of fat storage cell proliferation, interstitial fibrosis reduced, before and after treatment, the difference was not significant (P> 0.05). Conclusion: HBO treatment of CCH can increase the right branch of hepatic artery and portal vein blood flow, improve clinical symptoms and liver function, effectively reduce the liver cells and cholestasis of the bile duct and liver tissue ultrastructure damage