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目的 :为提高对西藏高原地区酒精性肝硬化的认识。方法 :对我院 1 990年 1月至 1 998年 1 2月所收治的 91例确诊病例进行统计分析。结果 :西藏高原世居藏族的酒精性肝硬化占我院同期住院全部肝硬化的 4 2 3%。 2 5岁以前开始饮酒者 ,发生肝硬化的时间为 1 7 0± 5 9年 ,而 2 6岁以后开始饮酒者 ,发生肝硬化的时间为 31 4± 3 9年 ,差异非常显著 (P <0 0 1 )。每日饮入净乙醇量小于 2 50克者 ,发生肝硬化的时间为 2 6 3± 6 0年 ,而大于 2 50克者 ,发生肝硬化的时间为 1 2 9± 4 9年 ,差异非常显著 (P <0 0 1 )。世居藏族酒精性肝硬化的症状与平原地区者基本相同 ,体征中则无肝掌、蜘蛛痣与脾肿大。临床治愈出院的患者 ,87 5%经严格戒酒后病情一直稳定。结论 :饮酒起始年龄越小 ,饮酒量越大 ,发生肝硬化的时间越短。高原缺氧对世居藏族酒精性肝硬化的形成可能并未起促进作用。本组病例何以均无肝掌、蜘蛛痣与脾肿大这一临床表现特点 ,尚须进一步研究方能明了。患者临床治愈出院后 ,严格戒酒是稳定病情的关键措施。
Objective: To raise awareness of alcoholic cirrhosis in the Tibetan Plateau. Methods: A total of 91 confirmed cases from January 1990 to January 1998 were analyzed statistically. Results: Alcoholic cirrhosis of Tibetans living in Tibet accounted for 42.3% of all cirrhosis hospitalized in our hospital at the same period. People who started drinking before the age of 5 had cirrhosis of the liver at 170 ± 59 years, and those who started drinking after the age of 6 had a history of cirrhosis of 31 4 ± 39 years (P < 0 0 1). The daily intake of less than 2 50 grams of net ethanol were, the occurrence of cirrhosis of the time of 263 ± 6 0 years, and more than 2 50 grams, cirrhosis of the time was 129 ± 49 years, the difference was very Significant (P <0.01). Living Tibetan alcoholic cirrhosis symptoms and plain areas are basically the same, there is no sign in the liver palms, spider nevus and splenomegaly. Among the patients who were clinically discharged from hospital, 87.5% of them were stable after taking alcohol strictly. Conclusion: The lower the initial drinking age, the greater the alcohol consumption, the shorter the time of cirrhosis. Plateau hypoxia may not contribute to the formation of alcoholic liver cirrhosis in the Tibetan community. This group of patients why no liver palms, spider nevus and splenomegaly characteristics of this clinical manifestations, the need for further study to understand. Patients with clinical cure after discharge, strict alcohol abstinence is the key to stabilize the condition.