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肝性脊髓病临床少见,最早由Zieve(1960年)报告二例,笔者见到二例,现报告如下: 例1,朱××,男,39岁,工人。10年前患慢性肝炎,85年3月患肝硬化,门脉高压症、精索鞘膜积液(右)。85年4月劳累后出现精神症状,诊断“肝昏迷”,经治好转。5月发生消化道出血,9月来我院行“脾切+脾静脉分流+门奇离断”手术。86年2月发现双下肢渐无力,5月症状加重。不能行走,感觉及二便均正常。检查:慢性病容,面色灰暗,颈软,心、肺正常,腹部饱满,肝浊音界缩小,肝肋下未触及,无腹水征,神经系统:颅神经(一),双上肢正常,双下肢肌张力明显增高,肌力Ⅲ°～Ⅳ°,双膝腱反射亢进,双踝阵挛(+),
Hepatic myelopathy is clinically rare, the first reported by Zieve (1960) in two cases, the author saw two cases are reported as follows: Example 1, Zhu × ×, male, 39 years old, workers. 10 years ago suffering from chronic hepatitis, cirrhosis of the liver in March 1985, portal hypertension, spermatic cord effusion (right). 85 years April after exerting mental symptoms, the diagnosis of “hepatic coma”, the rule improved. Gastrointestinal bleeding occurred in May, in September our hospital “Spleen + splenic vein shunt + door odd off” operation. February 86 found that both lower extremities gradually weakness, symptoms increased in May. Can not walk, feel and two will be normal. Check: Chronic disease, dark complexion, neck soft, heart, lungs normal, full belly, reduced liver dullness, liver ribs untouched, without ascites sign, nervous system: cranial nerves (a), both upper extremities normal, Tension was significantly higher, muscle strength Ⅲ ° ~ Ⅳ °, double tendon hyperreflexia, double ankle clonus (+),