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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。
Objective: To observe the changes of hepatic blood flow, clinical symptoms, liver function and liver histology in patients with chronic cholestatic hepatitis (CCH) before and after HBO treatment. Methods: 30 cases of CCH were treated with pure oxygen (2.5 MPa, 2 h / d, 10 d / cyc, 6 cyc). Before and after treatment of hepatic hematoma instrument and Doppler ultrasound B hepatic blood flow diagram contractile and right portal vein blood flow; liver biopsy pathology. Take arithmetic mean t test. Results: After treatment, the contraction wave of hepatic blood flow diagram and the right branch of hepatic portal vein blood flow were significantly increased; the clinical symptoms and liver function of patients were significantly improved; among the 10 patients who underwent secondary liver biopsy before and after treatment, 9 cases of cholestasis And cholestasis of liver cells were alleviated. Seven patients had degeneration and necrosis of hepatic cells and reduced inflammation in portal area (P <0.05). 3 cases of liver fibrosis reduced (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, bile duct cholestasis and liver histological damage.